title: [Varicocele in the adolescent. What is the best surgical option?].
abstract: OBJECTIVE
  To compare three different surgical approaches for the performance of varicocelectomy in the pediatric population, analyzing their effectiveness and secondary complications.
  
  
  METHODS
  Over an eight year period 90 varicocelectomies were performed in 89 children with a mean age of 12 years (range 8-16). Patients were divided into three groups, in 21 cases laparoscopic approach was performed (Group 1), in 55 the Palomo's retroperitoneal approach (Group 2) and inguinal approach in 14 cases (Group 3). Preoperative demographic characteristics, and intraoperative data, followup and complications were analyzed.
  
  
  RESULTS
  Age, indication and follow-up time were similar in all three groups. Average surgical time were 36 minutes,34 minutes and 30 minutes respectively. Recurrences appeared in one (4%), 5 (9%) and 0 patients respectively. Postoperative hydrocele requiring surgical treatment appeared in 2 (9%), 4 (7%) and 0 respectively, with an incidence of hydrocele of 2 cases (9%), 5 (9%) and 1 (7%) which resolved during follow-up. One patient presented bleeding at the site of trocar insertion which was solved intraoperatively, and another patient in the laparoscopy group had a wound infection.
  
  
  CONCLUSIONS
  Comparisons between the three groups reveal that there were not significant differences, although the results were somewhat better in the inguinal approach group. Any technique has adequate results, with a total recurrence rate in our series of 6%, and 6% of hydroceles. The development of methods that will make possible to diminish hydrocele, such as lymphatic preservation, will give better general results.
authors.affiliation: Unidad de Urología Infantil, Hospital de Niños Exequiel González Cortés, Santiago, Chile. jmescala@clinicalascondes.cl
authors.forename: José M
authors.initials: JM
authors.lastname: Escala
authors.forename: Yair
authors.initials: Y
authors.lastname: Cadena
authors.forename: Sergio
authors.initials: S
authors.lastname: Valenzuela
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: López
authors.forename: Gabriela
authors.initials: G
authors.lastname: Retamal
authors.forename: Nelly
authors.initials: N
authors.lastname: Letelier
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zubieta
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D008297:Male; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*