title: Dye assisted lymphatic sparing subinguinal varicocelectomy. A prospective randomized study.
abstract: BACKGROUND
  Division of lymphatic vessels during varicocelectomy could lead to hydrocele formation and decrease in testicular function due to testicular edema. We determined if the use of methylene blue combined with optical magnification reduces the incidence of post-varicocelectomy hydrocele.
  
  
  METHODS
  Consecutive patients treated for varicocele at our institution were evaluated for inclusion. Participants were randomly allocated to receive either subinguinal varicocelectomy after 2 ml intratunical space injection of methylene blue and group 2 in whom no mapping technique was adopted during subinguinal varicocelectomy. After surgery, the patients were assessed at 2 weeks, 6 and 12 months for hydrocele, testicular edema, varicocele recurrence, atrophy, pain or other complications with mean follow-up was 15 ± 7 months.
  
  
  RESULTS
  Eighty patients with varicocele were randomized and completed the study. There were no intra complications in either group. In group (1) no patient had a hydrocele after surgery. By contrast, in group (2) there were four cases of secondary hydrocele (10%; P = 0.041)); no testicular hypertrophy was observed following lymphatic sparing surgery; One patient in each group had varicocele recurrence. Pregnancy was reported in 30 patients (37.5%) during the follow-up period, 17 of them (42.5%) were group (1) difference was not significantly different among both groups.
  
  
  CONCLUSIONS
  Subinguinal varicocelectomy using combination of optical magnification and lymphatic staining (methylene blue) offers simple and quick preservation of the draining lymphatic vessels and avoids secondary hydrocele formation. ClinicalTrials.gov ID: NCT01259258.
authors.affiliation: Mansoura University Hospital, General Surgery Department, Mansoura, Egypt. elnakeebayman@yahoo.com
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abd Ellatif
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Ashraf M
authors.initials: AM
authors.lastname: Shoma
authors.forename: Ashraf E
authors.initials: AE
authors.lastname: Abbas
authors.forename: Walleed
authors.initials: W
authors.lastname: Askar
authors.forename: Nashat
authors.initials: N
authors.lastname: Noman
mesh_terms: D000293:Adolescent; D000328:Adult; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D005240:Feasibility Studies; D006801:Humans; D007202:Indicators and Reagents; D042601:Lymphatic Vessels; D008297:Male; D008751:Methylene Blue; D055096:Optical Devices; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013733:Testicular Diseases / Q000209:etiology / Q000517:prevention & control; D006848:Testicular Hydrocele / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult
chemical_list: D007202:Indicators and Reagents; D008751:Methylene Blue