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Comparison of post-operative testicular blood flow and volume in artery sparing and non-artery sparing laparoscopic varicocelectomy
alireza alamsahebpour, fellow of pediatric urology1, guy Hidas, fellow of pediatric urology1, yasaman alamsahebpour, undergrad student in Physiology and neuroscience2, Tandis soltani, medical student1, maryellen pribish, nurse practitioner1, blake selby, nurse practitioner1, irene McAleer, pediatric urologist1, gordon McLorie, pediatric urologist1, antoine khoury, pediatric urologist1.
1university of california at Irvine, orange, CA, USA, 2university of california at San Diego, San Diego, CA, USA.
BACKGROUND: To evaluate whether non-artery sparing (NAS) laparoscopic varicocelectomy (LV) has deleterious effects on post-operative testicular catch-up growth and on testicular blood flow
METHODS: We retrospectively collected data on patients who underwent LV in our institute and had performed pre and postoperative US. Patients were divided into two groups. Group 1 underwent artery sparing (AS) LV (10 patients) and group 2 underwent NAS LV (13 patients). Demographic clinical and ultrasonic parameters were collected. Testicular volume was measured using the Lambert Formula (L*W*D*0.71) based on ultrasound volume measurements. Testicular volume change after surgery was calculated for each patient. In order to measure testicular catch-up growth (in the cases were the indication for surgery was low left testicular volume) we calculated the volume differential between the left and right testis before and 3-6 month after surgery.
RESULTS: Demographic and clinical characteristics were similar in both groups. Testicular Color-Doppler blood flow was normal in all patients after surgery. No atrophy was observed in any operated testes and all the testes showed increased volume after surgery. Mean testicular volume change after surgery for left testes was 99 %( ±79%) for NASLV and 46.3 %( ±14%) for AS (p=0.09). Testicular catch up growth measured by mean testicular volume differential between the left and right testis[(R-L/R)*100] was 34.73%(±10.6%) before to 22.26%(20.8%) after surgery for the ASLV group (p=0.18) and 35.23%(±10%) before to 6.94% (±29%)after surgery for the NASLV group (p=0.01).
CONCLUSIONS: NAS LV does not increase the risk of testicular ischemia and atrophy. Catch up testicular growth was significantly higher when NASLV was performed. Source of Funding: none
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