Research and Reports in Urology (Dec 2020)

Factors Associated with Varicocele Recurrence After Microscopic Sub-Inguinal Varicocelectomy

  • Alkhamees M,
  • Bin Hamri S,
  • Alhumaid T,
  • Alissa L,
  • Al-Lishlish H,
  • Abudalo R,
  • Iqbal Z,
  • Albajhan G,
  • Alasker A

Journal volume & issue
Vol. Volume 12
pp. 651 – 657

Abstract

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Mohammad Alkhamees,1 Saeed Bin Hamri,2,3 Turki Alhumaid,2 Layla Alissa,3 Haleema Al-Lishlish,3 Rula Abudalo,3 Zafar Iqbal,3 Ghufran Albajhan,4 Ahmed Alasker2,3,5 1Department of Urology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 2Division of Urology, Department of Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia; 3King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia; 4Twareat Medical Center, Al Khobar, Saudi Arabia; 5King Abdullah International Medical Research Center (KAIMRC), Riyadh 11426, Saudi ArabiaCorrespondence: Mohammad AlkhameesDepartment of Urology, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi ArabiaTel +966 554463808Fax 00 966 164042500 Email [email protected]: This study has been conducted to identify the rate of varicocele recurrence in patients who underwent microscopic subinguinal varicocelectomy at our center. We also aimed to determine the contributing factors to varicocele recurrence.Patients and Methods: A total of 34 married male patients who underwent microscopic sub-inguinal varicocelectomy were retrospectively included in this study. The medical records of recruited patients were reviewed. The diagnosis of varicocele was based on physical examination, while recurrent varicocele was diagnosed based on both physical examination and colored doppler ultrasound. We investigated contributing factors to varicocele recurrence, including demographic characteristics (such as body mass index), clinical (varicocele grade and size of dilated veins), and laboratory data (semen analysis). Patients were followed up at 3 and 6 months after surgery.Results: The mean age of patients was 32.53 years. The majority of patients had left-sided varicocele (70.6%) and underwent surgery due to scrotal pain (82.4%), with a mean operation duration of 92 minutes. Left-sided varicoceles were grade II in 51.7% of patients, while right-sided varicoceles were grade II in 16.1% of patients. Recurrence occurred in 2.9% after 3 and 6 months. Pain recurred in 8.8% and 10.5% of patients at 3 and 6 months, respectively. Pregnancy rates were 44.1% at 3 months and 11.8% at 6 months after surgery. The grade of varicocele (P = 0.24) and the size of the left dilated vein (P = 0.002) was significantly associated with recurrence.Conclusion: There was a significant association of advanced grade on the left side and large vein diameter before and after surgery with an increased rate of recurrence; however, due to the small sample size of our study, more and larger studies are still warranted.Keywords: varicocele, recurrence, microscopic varicocelectomy, subinguinal

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