Varicocele and varicose veins compared. A basis for logical surgery |
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| Authors: | A R Dennison D J Tibbs |
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| Institution: | 1. Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran;2. Center of Physiology Researcher, Kerman University of Medical Sciences, Kerman, Iran;3. Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;4. Department of Urology, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran;5. Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran;6. Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran;7. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Kerman, Iran;1. Geisel School of Medicine at Dartmouth, Hanover, NH;2. Division of Vascular Surgery, University of Michigan, Ann Arbor, Mich;3. Department of Interventional Radiology, University of Michigan, Ann Arbor, Mich;1. MVZ Dr. Zollmann und Kollegen, Jena, Germany;2. Praxis für Venen- und Hauterkrankungen, Jena, Germany;3. Department of Dermatology, Ruhr-University Bochum, Bochum, Germany;1. Institut Pasteur de Tunis, LTCII, LR11IPT02, Tunis 1002, Tunisia;2. Neurological Department of Charles Nicolle Hospital, Tunis, Tunisia;3. Tunis El Manar University, Tunis 1068, Tunisia |
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| Abstract: | In the past only large symptomatic varicoceles were treated surgically, but this has changed now that they are believed to be a cause for infertility. Ten patients have been studied using the Doppler flowmeter and phlebography to compare varicoceles and varicose veins in the legs and to decide whether or not the same principles apply in their surgical treatment. These studies have confirmed a similar mechanism of retrograde flow from above a pumping mechanism to below it. Surgery must aim at effective and complete interruption of the source of the downflow. This requires ligation of the testicular vein either at sufficiently high level to insure that it is above any major branches or that these are included in the ligation. There is no danger of causing venous obstruction because a varicocele would not develop without the existence of a massive alternative venous outlet. |
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