What are potential drawbacks of the retroperitoneal approach for treatment of varicocele?

Updated: Jan 02, 2019
  • Author: Wesley M White, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The retroperitoneal approach offers great proximal control of the spermatic vein near its insertion at the renal vein, and this approach may be accomplished laparoscopically. Although this approach to varicocele ablation remains popular among pediatric urologists, it has the following potential drawbacks:

  • A high recurrence rate (nearly 15%), due to inguinal and retroperitoneal collateral veins
  • Failure to ligate fine periarterial veins when the testicular artery is preserved
  • Inability to preserve lymphatics
  • Potential hydrocele formation when the artery and vein are ligated en bloc

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