SIMULTANEOUS MICROSURGICAL VASAL RECONSTRUCTION AND VARICOCELE LIGATION - SAFETY PROFILE AND OUTCOMES

Objectives. Simultaneous varicocele ligation and vasal reconstruction has previously been avoided because of concern regarding testicular de vascularization, This study sought to investigate the safety of a simu ltaneous combined approach in the hands of an experienced microsurgeon . Methods, A retrospective review was conducted of the records of 47 m en who underwent vasal reconstruction, 10 (21%) of whom had simultaneo us ligation of a clinically palpable varicocele. Specific attention wa s focused on the development of postoperative testicular atrophy and h ydrocele and the analysis of postoperative semen parameters. Results, No patient developed postoperative testicular atrophy or hydrocele. No statistically significant difference existed in postoperative seminal parameters between those patients who had vasal reconstruct-ion alone and those who had a combined procedure, Conclusions. In the hands of an experienced microsurgeon, simultaneous vasal reconstruction and var icocele ligation is a management strategy that has an excellent safety profile. This approach is not recommended for the occasional microsur geon. (C) 1997, Elsevier Science Inc. All rights reserved.