title: Laparoendoscopic single site varicocele ligation: comparison of testicular artery and lymphatic preservation versus complete testicular vessel ligation.
abstract: OBJECTIVE
  We compared postoperative outcomes in patients treated with laparoendoscopic single site varicocele ligation with or without testicular artery and lymphatic preservation.
  
  
  METHODS
  A total of 80 patients with left varicocele were randomly divided into 2 groups and treated with laparoendoscopic single site varicocele ligation with preservation of the testicular artery and lymphatics (40 in group 1) or complete ligation of the testicular vessels and lymphatics (40 in group 2). Operative time, hospital stay, return to normal activity, postoperative visual analog scale pain scores and complications were analyzed. In patients with subfertility preoperative and 3-month postoperative semen analyses were performed. In patients with scrotal pain preoperative and 12-month postoperative visual analog scale pain scores were analyzed.
  
  
  RESULTS
  A total of 35 patients per group completed the study. Hospital stay, return to normal activity and postoperative pain scores did not differ between the groups. No major complications were observed. Mean ± SD operative time was 60.7 ± 10.7 and 48.6 ± 6.0 minutes in groups 1 and 2, respectively (p <0.001). Patients with subfertility, including 22 in group 1 and 21 in group 2, showed improved semen parameters 3 months postoperatively but postoperative values did not differ between the groups. The 17 patients in each group with scrotal pain showed decreased pain scores 12 months postoperatively with no difference between the groups.
  
  
  CONCLUSIONS
  Laparoendoscopic single site varicocele ligation is feasible. No differences in postoperative outcomes and complications were observed when preserving or not preserving the testicular artery and lymphatics.
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dong Hyuk
authors.initials: DH
authors.lastname: Kang
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Jung Ki
authors.initials: JK
authors.lastname: Jo
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Ham
authors.forename: Kang Su
authors.initials: KS
authors.lastname: Cho
authors.forename: Ki Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Tae Hyo
authors.initials: TH
authors.lastname: Kim
authors.forename: Seung Wook
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000328:Adult; D001158:Arteries; D006801:Humans; D010535:Laparoscopy; D008026:Ligation / Q000379:methods; D042601:Lymphatic Vessels; D008297:Male; D011446:Prospective Studies; D013737:Testis / Q000098:blood supply*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*