Based on current available r and omized controlled trials , there is low to moderate level of evidence that radiological or surgical treatment of adolescent varicocele is associated with improved testicular size/growth and sperm concentration .
BACKGROUND The prevalence of varicoceles is as high as 15 % in children and adolescents .
Optimal management of varicoceles has not been consoli date d. Options include observation , radiological intervention , or surgical varicocelectomy .
OBJECTIVE Herein , we aim to assess the outcomes of radiological and surgical interventions for varicocele in children and adolescents evaluated by RCTs .
Dye-assisted lymph vessels sparing laparoscopic varicocelectomy.
OBJECTIVE Hydrocele , the main complication of laparoscopic varicocelectomy , is thought to result from a disruption of gonadal lymphatics . The aim of this study was to evaluate the effectiveness of patent blue V dyeing to identify and preserve lymphatic vessels and to assess whether the lymphatic sparing technique avoids postoperative hydrocele in adolescent boys undergoing a laparoscopic procedure . MATERIAL S AND METHODS Fifty-two ( 52 ) boys affected by varicocele Grade III ( range , 12 - 16 years ) underwent a left-sided laparoscopic varicocelectomy . Twenty-six ( 26 ) boys were r and omly assigned to a lymphatic nonsparing ( LNS ) group , and the others to a lymphatic sparing ( LS ) group . Before surgery in the LS group , 2 mL of patent blue V was injected under the tunica dartos on the left side . RESULTS All varicocelectomies were performed laparoscopically . Lymphatic vessels were identified in 23 ( 88.5 % ) boys of the LS group . In the remaining three ( 11.5 % ) , the lymphatics could not be identified clearly . No adverse local or generalized reactions were noted . At a mean follow-up of 14 months , no recurrent varicocele or testicular volume reduction were detected . Hydrocele developed in 4 LNS patients and 1 was operated on . No patient from the LS group developed a hydrocele . CONCLUSIONS Staining gonadal lymph vessels with patent blue V is an effective and simple method of visualization of the lymphatic drainage from the testis . Blue-stained lymph vessels could be readily distinguished and preserved during a laparoscopic varicocelectomy , which results in a decrease of hydrocele development . To vali date an efficacy of vital staining of lymphatic vessels in avoiding hydrocele formation , a larger series and longer follow-up are necessary
Based on current available r and omized controlled trials , there is low to moderate level of evidence that radiological or surgical treatment of adolescent varicocele is associated with improved testicular size/growth and sperm concentration .
BACKGROUND The prevalence of varicoceles is as high as 15 % in children and adolescents .
Optimal management of varicoceles has not been consoli date d. Options include observation , radiological intervention , or surgical varicocelectomy .
OBJECTIVE Herein , we aim to assess the outcomes of radiological and surgical interventions for varicocele in children and adolescents evaluated by RCTs .