Urology & Andrology
Varicocele is one of the causes of male factor infertility which can be treated through surgical correction. The commonly applied method is a surgical technique named Testicular Vein legation (TV ligation) which gives an improvement in semen quality with marginal pregnancy rate. Sadly, many of the patients are permanently rendered sterile, and up to thirty percent of them experience some complications like re-appearance of Varicocele or collection of fluid around the testicles called Hydrocele. Few surgeons offer laparoscopic TV ligation. But even in this case the pregnancy rate and complication rate are no better than TV ligation. The reasons for this poor revolt and high complication are the inability to identify and preserve the major blood supply to the testis and its lymphatic and incomplete removal of the pathogenic venous channels owing to the micro sizes of these structures.
The new microsurgical technique (MSV) makes use of an operating microscope and microsurgical instruments to correctly identify these microstructures and aid in the preservation of the testicular blood supply and lymphatic channels and to completely remove the pathogenic venous channels, the results of which are truly encouraging. The semen quality improvement rate is over ninety percent and pregnancy rates stand at around eighty percent. More importantly, the complication rate is negligible with 0.2 -1%. The other advantage of MSV is that it is much less painful when compared to TV ligation and the patient can be back to work on the third day of surgery. Even today over 98 % of patients undergo TV ligation, as a result of the low awareness of the advantages of this procedure.
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