Table 2. Comparison of the Common Methods Used for the Treatment of Varicoceles
| Percutaneous Occlusion | Surgical Repair | ||||||
| Retrograde | Anterograde | Laparoscopic | Open retroperitoneal/high ligatio | Open inguinal ligation | Open subinguinal ligation | Microsurgical | |
| Unperformable rate | 8%–30% | Low | 0%–11% | Low | Low | ||
| Recurrent/Persistence rate | 3%–11% | 5%–9% | 6%–15% | 10%–45% | 0%–2% | ||
| Risk of arterial/lymphatic injury | Low | Very low | Moderate | High | Very low | ||
| Complication rate | 9%–30% | 3%–8% | 8%–12% | 5%–30% | <5% | ||
| Procedure time (mins/side) | 30–60 | 10–15 | 30–80 | 20–40 | 25–60 | ||
| Comments |
Local anesthesia
High unperformable rate for right side
Cost depends on method used
Risks of radiation exposure, contrast allergy, venous
thrombosis or embolus, coil migration.
|
Local anesthesia
Lower complication and recurrence rate than retrograde
occlusion
Risks of radiation exposure, contrast allergy, venous
thrombosis or embolus, coil migration.
|
High cost
General anesthesia required
Risks of injury to viscera, peritonitis, arterial injury,
lymphatic injury air embolism penumothorax subcutaneous emphysema deep
vein thrombosis penumoscrotum
|
Regional or general anesthesia required
High risks of arterial injury leading to testis atrophy
and lymphatic injury leading to hydrocele
High recurrence/persistence rate because of missed
venous returns
|
Local, regional, or general anesthesia
Lowest complication and recurrence rate
|
||
| References | 110,111,112, 113,114,115, 116,117 |
118,119,120 | 117,121,122, 123,124 |
117,122, 115–133 |
5,25,131,132, 133,134 |
||