Number №1, 2019 - page 115-119

The results of the use of minimally invasive scrotal access to perform microsurgical varicocelectomy DOI: 10.29188/2222-8543-2019-11-1-115-119

Efremov E.A., Kastrikin Yu.V., Mel'nik Ya.I., Simakov V.V., Edoyan T.A., Butov A.O
Information about authors:
  • Efremov E.A. – Dr. Sc., Professor of the Department of Urology, Andrology and Oncourology of Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of Russia, Head of the Department of Andrology and Human Reproduction of N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation , e-mail: konfandrology@rambler.ru;
  • Kastrikin Yu.V. – Postgraduate Student, Department of Urology, Andrology and Oncourology of Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of Russian Federation, e-mail: yurii_kn@mail.ru; 
  • Melnik Ya. I. – researcher of  the Department of Andrology and Human Reproduction of N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation , e-mail: melnik-kk@mail.ru; 
  • Simakov V.V. – researcher of  the Department of Andrology and Human Reproduction of N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, e-mail: t9852887685@gmail.com
  • Edoyan T.A. – Postgraduate Student of  N. Lopatkin Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, e-mail: tigran.yedoyan.ty@gmail.com
  • Butov A.О. – Postgraduate Student, Department of Urology, Andrology and Oncourology of Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health Russian Federation, e-mail: al_vasenov@mail.ru;
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Varicocele is a pathology, which is determined in 11.7% of adult men and in 25.4% of men, with abnormalities in the spermogram. the relevance of developing an optimal minimally invasive, safe and highly efficient operational method for performing varicocelectomy is associated with both clinical and medical-economic aspects.

Purpose: Evaluation of the efficacy and safety of the surgical treatment of varicocele using minimally invasive scrotal access and the use of microsurgical techniques.

Materials and methods: In the N. Lopatkin Scientific Research Institute of Urology & Interventional Radiology – branch of the federal state budgetary institution "National Medical Research Radiological Center" of the Ministry of health care of Russia for the period 2010 – 2018 under the supervision there were 1920 men who have a fruitless marriage and varicocele, confirmed by an ultrasonic method of examining the vessels of the scrotum organs using dopplerography. Of these, 1750 (91.1%)we underwentsurgery for pathospermia. The age of men who underwent surgical treatment varied from 18 to 52 years (on average 28 + 4.2 years) and all had a fruitless marriage for more than one year in history. The choice of surgical benefits for all patients was the method of minimally invasive microsurgical varicocelectomy with scrotal access, using optical magnification (4.5 D and more).

Results: The effectiveness of minimally invasive microsurgical varicocelectomy with scrotal access after the operation was 78.2% (n = 1369) of cases, where statistically significant qualitative and quantitative improvement of spermatogenesis parameters was registered within 12 months after surgical treatment. In 5 (0.3%) men, the appearance of a reactive hydrocele was noted, which was selfsustaining within a month. Of these, in 4 (80%) cases, it was necessary to perform a single aspiration of the aqueous fluid under ultrasound control without additional administration of ethanol solution, in one case (20%) – surgical treatment. A relapse of the disease was registered only in 8 patients (0.5%).

Conclusion: The method of minimally invasive microsurgical varicocelectomy with scrotal access is characterized by a high degree of efficiency and safety.

Authors declare lack of the possible conflicts of interests.

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varicocele, pathospermia, male infertility

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