title: Varicocele surgery: 10 years of experience in two pediatric surgical centers.
abstract: OBJECTIVE
  The study was designed to compare recurrence rates and complications after laparoscopic versus open varicocele surgery in children.
  
  
  METHODS
  A retrospective case-note review of all varicocele surgery over a 10-year period (April 1999-March 2009) in two pediatric surgical centers was performed. Multivariate analysis using logistic regression was performed using SPSS Statistics version 18 (SPSS Inc., Chicago, IL).
  
  
  RESULTS
  Thirty-seven patients had varicocele surgery during the study period. The median age at surgery was 14 years (range, 11-16 years). Most children had left-sided Grade 2 varicocele. Twenty-five (68%) primary procedures were laparoscopic (17 artery-sparing), and 12 (32%) procedures were open (9 artery-sparing). Six (16%) children had recurrence, and 6 (16%) had postoperative hydrocele. Recurrence rates after laparoscopic (16%) and open (17%) surgery were similar. Increasing age significantly decreased recurrence (odds ratio, 0.373; 95% confidence interval 0.161-0.862; P = .021). Although laparoscopy was associated with higher rates of postoperative hydrocele (odds ratio, 2.817; 95% confidence interval, 0.035-3.595; P = .380) and artery-sparing ligation was associated with higher rates of recurrence (odds ratio, 2.667; 95% confidence interval, 0.022-4.235; P = .787), these associations were not statistically significant.
  
  
  CONCLUSIONS
  The best results of varicocele surgery in terms of recurrence and postoperative hydrocele were achieved by open mass ligation; however, larger prospective studies are warranted.
authors.affiliation: Chelsea and Westminster Hospital, London, United Kingdom. anindya.niyogi@nhs.net
authors.forename: Anindya
authors.initials: A
authors.lastname: Niyogi
authors.forename: Shalini
authors.initials: S
authors.lastname: Singh
authors.forename: Azrina
authors.initials: A
authors.lastname: Zaman
authors.forename: Ayesha
authors.initials: A
authors.lastname: Khan
authors.forename: Cezar
authors.initials: C
authors.lastname: Nicoara
authors.forename: Munther
authors.initials: M
authors.lastname: Haddad
authors.forename: Nicholas
authors.initials: N
authors.lastname: Madden
authors.forename: Simon A
authors.initials: SA
authors.lastname: Clarke
authors.forename: Azad
authors.initials: A
authors.lastname: Mathur
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsang
authors.forename: Milind
authors.initials: M
authors.lastname: Kulkarni
authors.forename: Ashish
authors.initials: A
authors.lastname: Minocha
authors.forename: Diane
authors.initials: D
authors.lastname: DeCaluwé
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000209:etiology; D014646:Varicocele / Q000601:surgery*