(Micro)surgical and percutaneous procedures in the management of varicocele: 25 years of experience.
BACKGROUND
The effectiveness of different procedures for varicocele varies in terms of recurrence, sperm-count improvement, pregnancies and deliveries.


OBJECTIVE
To determine if microsurgical varicocelectomy plus antegrade sclerotherapy under local anaesthesia is the first choice surgical modality to treat this disease.


METHODS
Since 1983 out of more than 1000 patients treated for primitive varicocele, we considered 800 patients with a follow-up of two years. Out of them 195 underwent a "standard" surgical procedure, 280 received a percutaneous sclerotherapy and 325 were managed microsurgically. Out of the last group, the first 90 cases were operated by microsurgical technique alone, while the remaining were offered microsurgery plus antegrade sclerotherapy.


RESULTS
Traditional surgery had the higher incidence of relapse whereas percutaneous sclerotherapy needed use of Gianturco's coil to minimize relapses. Microsurgical technique plus antegrade sclerotherapy had the lower incidence of failures.


CONCLUSIONS
An extensive experience through the years led us to consider microsurgery plus sclerotherapy as the first choice treatment for varicocele.
Urology Unit, Arcispedale S. Anna, Ferrara, Italy. gianniughi@ospfe.it
Gianni
G
Ughi
Lucio
L
Dell'Atti
Consuelo
C
Ricci
Giovanni Pietro
GP
Daniele
D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D015911:Sclerotherapy / Q000379:methods; D013997:Time Factors; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult