LAPAROSCOPIC LIGATION OF VARICOCELES - AN ANATOMICALLY SUPERIOR OPERATION

Since December 1991, 25 consecutive symptomatic male patients with 26 varicoceles were treated by laparoscopic ligation of internal spermati c veins under general anaesthesia. Twenty-one patients had either scro tal discomfort or painful swelling and four patients presented with in fertility. The mean follow-up period is 5 months (range 3 weeks to 9 m onths). The procedure has provided a satisfactory outcome in 19 out of 21 patients (90.5%) with scrotal symptoms. Of the four patients prese nting with infertility due to oligospermia, three had significantly el evated sperm counts at 3 months which resulted in one pregnancy. So fa r there has been no recurrence of the varicocele. The main potential a dvantage of the laparoscopic approach is better visualisation of the a natomy, especially the testicular artery and the collateral venous cir culation at the level of the internal inguinal ring. In addition to be ing less invasive with implied benefits, the endoscopic procedure has enabled identification of multiple veins in 22 out of 26 (84.6%) varic oceles in our series.