Recurrence of varicocele after high retroperitoneal repair: Implications of intraoperative venography

Purpose: We determined whether intraoperative venography results in a decre ased recurrence rate after varicocele repair in adolescence. Materials and Methods: We evaluated 177 male adolescents 14 to 19 years old who underwent varicocele repair via the high retroperitoneal approach with artery sparing and intraoperative venography. Results: Overall the recurrence rate was 2.8% (5 of 177 cases) in the venog raphy group and 11% in historical controls without venography. We identifie d left-to-right cross communicating vessels in 3 patients with recurrence. Intraoperatively venography revealed nonligated vessels in 21 patients (12% ), resulting in revision and repair during the same procedure. Conclusions: Intraoperative venography seems to decrease the rate of recurr ence. Left-to-right cross communicating vessels may be present in some adol escents with recurrence after varicocelectomy.