Introduction. Varicocele is varicose veins of the spermatic cord. It is a widespread disease found in 16.2% of patients. Combination of primary varicocele and infertility is observed in 35% and secondary infertility and varicocele — in 80%. The positive effect of surgical treatment on spermatogenesis in patients with varicocele is noted by many authors. Improving spermatopoietic testicular function up to a 5-year period of the disease is much better than over 5 years.
Materials and methods. The study included 43 patients operated on in the clinic of general surgery with aftercare of the Zaporozhye State Medical University on the basis of the Zaporozhye Municipal Clinical Hospital of emergency care, with the diagnosis of varicocele on the left during the period 2009–2011. The age of patients was 16–31 years, mean age was 19.5 years. 24 (55.81%) patients (group 1) underwent conventional Ivanissevich surgery. 19 (44.19%) patients (group 2) were performed minimally invasive surgery interventions (15 (78.95%) — laparoscopic ligation of the veins, 4 (21.05%) — endovascular vein embolization of the left testicle).
Results and discussion. The results of our surgical treatment of varicocele were excellent and good (92.3%). In group 1 patients, the average stay in the hospital after surgery was 6.7 bed-days, in group 2 — 1.6 bed-days. The decrease or disappearance of varicocele within the first day after surgery was observed in 94.6% of patients. However, the final therapeutic effect on the disappearance of the varices manifested in 3–6 months. Within the first month the varicocele disappeared in 99.3% of patients. The number of postoperative complications was 0% in the group 1, and 0.33% in the group 2 (1 patient in the late postoperative period was noted the development of hydrocephalus of mucous tunics of the left testicle).
Conclusion. Among all the operations for varicocele directed at the intersection of the internal spermatic vein, endoscopic surgery is the most progressive. It is less traumatic to the patient, but due to the fact that the testicular vein is easy to look all over, the relapse rate cut to a minimum. In addition, endoscopic surgery is the only operation in which a one-stage treatment of bilateral varicocele is possible. For all other methods it requires a separate transaction for each part. In addition, endoscopic surgery is the most optimal method for the treatment of recurrent varicocele. This is associated with an ability to observe spermatic vein almost in its entirety during the operation. The use of laparoscopic excision of the internal spermatic vein for varicocele has allowed us to significantly reduce the time of hospitalisation and duration of surgery, minimizing risk of postoperative complications, decrease the number of dressings used at the postoperative period.