Testicular vein syndrome and its treatment with a laparoscopic approach.
OBJECTIVE
Testicular vein syndrome (TVS) is a rare cause of ureteral obstruction. Only 5 previous cases are on record in the literature, and no review exists on this topic to date. Laparoscopic treatment has never been mentioned in the management of TVS.


METHODS
We reviewed the literature related to this unusual entity to clarify the preoperative evaluation and the management of TVS. For this purpose, the data related to all the 5 cases previously reported so far in the English literature have been reviewed. Also, we  report the sixth case of TVS, and the first patient to be successfully treated with the laparoscopic approach. This was a 37-year-old male with a 6-month history of left loin pain. Preoperative diagnosis was confirmed by CT-Urography.


RESULTS
Our patient underwent laparoscopic  excision of the left testicular vein followed by ureteroureterostomy in a single sitting. The laparoscopic transperitoneal approach was used. Histopathological examination of the vein showed normal venous tissue. This is the sixth reported case of TVS and the first to be successfully treated  with a laparoscopic technique.


CONCLUSIONS
A laparoscopic approach is safe and effective for treating patients with TVS with the common advantages of minimal invasiveness and better visualization of the complex anatomy of the retroperitoneum. Thus, it should be the treatment of  choice for TVS.
Department of Urology, Bhopal Memorial Hospital & Research Centre, Bhopal, India.
Nand Kishore
NK
Arvind
Onkar
O
Singh
Shilpi Singh
SS
Gupta
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013577:Syndrome; D013737:Testis / Q000098:blood supply*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D014680:Veins / Q000002:abnormalities*