A study of super-high ligation and intraoperative venography in varicocele

Kim, Jong Hyun; Kim, Young Chan; Choi, Hyung Ki

Abstract

In 41 cases of patients with varicocele, a new operative method which involves a higher incision level(12th rib) than any other method used previously was performed with intra-operative venography. The following results were obtained. 1. This study has allowed us to achieve a low recurrent rate(3%). 2. On venographic findings, 13 cases(32%) showed only one internal spermatic vein without any other central collateral vein and 28 cases(68%) revealed more than two central collateral veins. The central collateral veins were found at the level of inguinal area in all 28 cases, anterior superior iliac spine in 10 cases, and at the 12th rib level in 5 cases. 3. 3 Recurrent cases after previous high ligation originated from missed central collateral veins above the level of anterior superior iliac spine. Based on the above results. We concluded that the most common etiology of recurrent varicocele seems to be residual central collateral veins and it seems to be that higher ligation sites offer better operative results. A new operative approach in this study which involved a higher level of ligation than any other approach offered high success rate. and the intra-operative venography prevented us from missing all ligation of central collateral veins.