Varicocoele
Varicocoele
- Acute onset often due to left renal vein compression from renal cell tumour
- More common on the left
- Associated with oligospermia
Indications
- Male infertility
- Scrotal discomfort
Treatment options
- Radiological embolisation
- Laproscopic division of varicocole from within peritoneal cavity
- Surgical approach at level of internal ring
Surgical Procedure
- GA + supine
- Dissect down to testicular vein
- Make incision over internal ring parallel to inguinal ligament
- Divide external oblique aponeurosis, visualise cord and split spermatic fascia longitudinally to expose testicular veins (from pampiniform plexus)
- Isolate and divide vein
- Separate vein from vas and testicular artery
- Ligate and divide with absorbable sutures
- Close
- Repair external oblique aponeurosis with absorbable subcuticular suture
- close skin incision with subcuticular non-absorbable suture
