IDIOPATHIC VARICOCELE

Abstract

It was possible to reexamine 135 patients out of 243, who were operated on idiopathic varicocele in the urological clinic of the University of Wurzburg. In 71 cases the operation was carried out according to Palomo and in 64 cases according to Bernardi. In 8 cases of the Bernardi-method a varicocele-recurrence was observed (3 of our patients and 5 originally treated elsewhere). In all these cases the recurrence was due to missed spermaticous veins. In none of the cases of the Palomo-method was a recurrence observed. Hydroceles were observed in both methods. 12.5% Palomo and 7.8% Bernardi. Only 1 case of epididymitis was observed. Testicularatrophy did not take place. These results show the Palomo-method to be the one of first choice. The operation is carried out through a grid-iron incision in the left hypogastrium with supranguinal resection of the spermatic vessels. According to Schramek and Riedl (1981) various different methods were applied for the treatment of idopathic varicoceles in German speaking countries. At this point in time there is general agreement that the spermatic vessels should be ligatured above the superior inguinal ring. However there is a discrepancy in opinion as the topographical level of the ligature and whether the internal spermatic artery should also be ligatured. This retrospective analysis is carried out to clarify these discrepancies, comparing the complications of both methods and explaining why the access should be placed immediately above the superior inguinal ring.