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.