Modified Palomo Surgery For Treatment Of Varicocele(Report 35 Cases)

Introduction Varicoceles are abnormally dilated testicular veins (pampiniform plexus) of in the scrotum, which is normally secondary to internal spermatic vein reflux. Varicocele is found in approximately 15% of the general population, 35% of men with primary infertility and in 75-81% of men with secondary infertility. It is more common on the left side. In adolescents, the incidence of varicocele is approximately 15%; the abnormality is extremely rare in prepubertal boys. Although most men with varicoceles are able to father children, there is abundant evidence that varicoceles are detrimental to male fertility. A study by the World Health Organization (WHO) on over 9,000 men showed that varicoceles are commonly accompanied by decreased testicular volume, impaired sperm quality, and a decline in Leydig cell function.Some report showed that 70% of healthy, asymptomatic military recruits with palpable varicoceles had an abnormality on semen analysis. Furthermore, studies in animals and humans suggest that varicoceles cause progressive testicular damage over time. It appears that surgical repair of varicoceles not only halts this declines in testicular function but often reverses it. Whether the improvements in semen parameters, seen in 80% of men after varicocele ligation, translate into improved pregnancy and delivery rates has been a matter of ongoing controversy.Objective: To evaluate the effects of modified Palomo surgery for varicocele ligation.Methods: 35 patients with varicocele were treated by modified Palomosurgery. An incision about 3cm above the inguinal ring was used to avoid injuring the inferior epigastria vasculature, and the internal spermatic veins were high ligated retroperitoneally.Results: The mean operation time was 25 minutes. All of the 35 cases had an obvious improvement of symptoms and signs. 28 cases were followed up for 1～2 years with a mean of 1.5 years without recurrence of the varicocele and atrophy of the testicles. 4 of 5 cases with oligospermia had an improvement in the sperm quality.Conclusion: The modified Palomo surgery is an effective and safe procedure for the treatment of varicocele with few complications and low recurrence rate.