摘要
To evaluate the effectiveness of microsurgical shunts for secondary varicocele repair after ligation-like procedures, focusing on long-term functional outco mes. Long-term survey (mean follow-up, 8.5 years) of infertile men after secon dary microsurgical reconstructive varicocelectomy. University-based medical cen ter. Thirty-four infertile men (group A, < 30 years of age; and group B, >30 ye ars) with recurrent palpable varicocele after varicocelectomy, according to Ivan issevich (n = 28), or after angiographic vein occlusion (n = 6). Ten patients presented bilateral recurren ce. Microsurgical shunts between spermatic vein and inferior epigastric vein. Sp erm count, pregnancy rate, and ultrasound evaluation of varicosity. Complete dis appearance of varicosity was achieved in 97.06%of patients, while in 2.94%, a consistent reduction in size was observed. In patients with severe infertility, a significant postoperative increase in seminal parameters was observed. Pregnan cy rates were 43.75%in group A and 22.22%in group B. Microsurgical drainage in patients with recurrent varicocele after ligation-like procedures was shown to be an effective minimally invasive treatment, with immediate hemodynamic recove ry of testicular venous outflow and excellent long-term results in patients wit h left or bilateral recurrences.
To evaluate the effectiveness of microsurgical shunts for secondary varicocele repair after ligation-like procedures, focusing on long-term functional outco mes. Long-term survey (mean follow-up, 8.5 years) of infertile men after secon dary microsurgical reconstructive varicocelectomy. University-based medical cen ter. Thirty-four infertile men (group A, < 30 years of age; and group B, >30 ye ars) with recurrent palpable varicocele after varicocelectomy, according to Ivan issevich (n = 28), or after angiographic vein occlusion (n = 6). Ten patients presented bilateral recurren ce. Microsurgical shunts between spermatic vein and inferior epigastric vein. Sp erm count, pregnancy rate, and ultrasound evaluation of varicosity. Complete dis appearance of varicosity was achieved in 97.06%of patients, while in 2.94%, a consistent reduction in size was observed. In patients with severe infertility, a significant postoperative increase in seminal parameters was observed. Pregnan cy rates were 43.75%in group A and 22.22%in group B. Microsurgical drainage in patients with recurrent varicocele after ligation-like procedures was shown to be an effective minimally invasive treatment, with immediate hemodynamic recove ry of testicular venous outflow and excellent long-term results in patients wit h left or bilateral recurrences.
