Journal of the Chinese Medical Association
Volume 73, Issue 5 , Pages 248-251, May 2010

Experience of Varicocele Management During Ipsilateral Inguinal Herniorrhaphy: A Prospective Study

  • Shiou-Sheng Chen

      Affiliations

    • Division of Urology, Taipei City Hospital Renai Branch, Taipei, Taiwan, R.O.C.
    • Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • William J. Huang

      Affiliations

    • Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr William J. Huang, Division of Urology, Department of Surgery, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 10 November 2009; accepted 11 March 2010.

Article Outline

Abstract 

Background

This was a prospective study to evaluate the experience of varicocele management during ipsilateral herniorrhaphy in an inpatient urology setting.

Methods

A total of 65 patients with varicocele and inguinal hernia scheduled for herniorrhaphy were included for evaluation. They were categorized into 3 groups. Group 1 (n = 20) had painful varicocele and underwent simultaneous herniorrhaphy and varicocelectomy; group 2 (n = 20) had asymptomatic varicocele and received simultaneous herniorrhaphy and varicocelectomy; and group 3 (n = 25) had asymptomatic varicocele and underwent herniorrhaphy only. We used the Bassini method for herniorrhaphy and inguinal microsurgical varicocelectomy for varicocele. Varicocele was diagnosed by physical examination and further confirmed by Doppler ultrasonography.

Results

The mean follow-up was 30.2 months (range, 6–56 months). Of the 20 subjects in group 1, complete resolution of scrotal pain was noticed in 14 (70%), and 2 (10%) had hydrocele after varicocelectomy. Of the 20 patients in group 2, 1 (5%) had hydrocele after surgery, and no hydrocele was noticed in group 3 after surgery. Mean operation time was significantly longer in group 1 (70.5 ± 15.2 minutes) and group 2 (69.8 ± 14.5 minutes) than in group 3 (38.2 ± 17.2 minutes). One case in group 1 had recurrent varicocele 6 months after surgery. Of the 25 subjects in group 3, 2 (8%) developed painful varicocele during the follow-up period, and both of them had indirect inguinal hernia and lower body mass index.

Conclusion

Simultaneous herniorrhaphy and varicocelectomy are suggested for patients who have inguinal hernia and ipsilateral varicocele, but the average operation time is significantly longer and there is a higher rate of hydrocele than with herniorrhaphy only.

Key Words:  body mass index , herniorrhaphy , inguinal hernia , microsurgical varicocelectomy , varicocele

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References 

  1. Jarrow JP . Effects of varicocele on male infertility . Hum Reprod Update . 2001;7:59–64
  2. Ribarski I, Lehavi O, Yogev L, Hauser R, Bar-Shira Maymon B, Botchan A, et al  USP26 gene variations in fertile and infertile men . Hum Reprod . 2009;24:477–484
  3. Witt MA , Lipshultz LI . Varicocele: a progressive or static lesion? . Urology . 1993;42:541–543
  4. Gorelick JI , Goldstein M . Loss of fertility in men with varico-cele . Fertil Steril . 1993;59:613–616
  5. Peterson AC , Lance RS , Ruiz HE . Outcomes of varicocele ligation done for pain . J Urol . 1998;59:1565–1567
  6. Yaman O , Ozdiler E , Anafarta K , Gogus O . Effects of micro-surgical subinguinal varicocele ligation to treat pain . Urology . 2000;55:107–108
  7. Levinger U , Gornish M , Gat Y , Bachar GN . Is varicocele prevalence increasing with age . Andrologia . 2007;39:70–80
  8. Holzheimer RG , Schreiber A . Inguinal hernia and concomitant varicocele mimicking mesh complication . Eur J Med Res . 2003;8:254–256
  9. Ruhl CE , Everhart JE . Risk factors for inguinal hernia among adults in the population . Am J Epidemiol . 2007;165:1154–1161
  10. Hendry PO , Paterson-Brown S , de Beaux A . Work-related aspects of inguinal hernia: a literature review . Surgeon . 2008;6:361–365
  11. Cayan S , Shavakhaov S , Kadioglu A . Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique . J Androl . 2009;30:33–40
  12. Silveri M , Adorisio O , Pane A , Colajacomo M , De Gennaro M . Subinguinal microsurgical ligation: its effectiveness in pediatric and adolescent varicocele . Scand J Urol Nephrol . 2003;37:53–57
  13. Cayan S , Acar D , Ulger S , Akbay E . Adolescent varicocele repair: long-term results and comparison of surgical techniques according to optical magnification use in 100 cases at a single university hospital . J Urol . 2005;174:2003–2007
  14. Amelar RD . Early and late complications of inguinal varicocelectomy . J Urol . 2003;170:366–369
  15. Kumanov P , Robeva RN , Tomova A . Adolescent varicocele: who is at risk . Pediatrics . 2008;121:53–57
  16. Handel LN , Shetty R , Sigman M . The relationship between varicoceles and obesity . J Urol . 2006;176:2138–2140
  17. Campanelli G , Canziani M , Frattini F , Cavalli M , Agrusti S . Inguinal hernia: state of the art . Int J Surg . 2008;6:526–528
  18. de Lange DH , Aufenacker TJ , Roest M , Simmermacher RK , Gouma DJ , Simons MP . Inguinal hernia surgery in the Netherlands: a baseline study before the introduction of the Dutch Guidelines . Hernia . 2005;9:172–177
  19. Calcagno C , Gastaldi F . Segmental testicular infarction following herniorrhaphy and varicocelectomy . Urol Int . 2007;79:273–275
  20. Nagle C , Clark K , Browning D , Howard R , Murphy J . Testicular ischemia and infarction following herniorrhaphy or varicocelectomy: evaluation by radionuclide imaging . Clin Nuclear Med . 1989;14:243–248
  21. Marte A, Sabatino MD, Borrelli M, Cautiero P, Romano M, Bessela A, et al. LigaSure vessel sealing system in laparoscopic Palomo varicocele ligation in children and adolescents . J Laparoendosc Adv Surg Tech A . 2007;17:272–275
  22. Karademir K , Senkul T , Baykal K , Ates F , Iseri C , Erden D . Evaluation of the role of varicocelectomy including external spermatic vein ligation in patients with scrotal pain . Int J Urol . 2005;12:484–488
  23. Yaman O , Ozdiler E , Anafarta K , Gogus O . Effects of micro-surgical subinguinal varicocele ligation to treat pain . Urology . 2000;55:107–108
  24. Cervellione RM , Corroppolo M , Bianchi A . Subclinical varico-cele in the pediatric age group . J Urol . 2008;179:717–719

PII: S1726-4901(10)70053-8

doi:10.1016/S1726-4901(10)70053-8

Journal of the Chinese Medical Association
Volume 73, Issue 5 , Pages 248-251, May 2010

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