COMPARATIVE ANALYSIS OF METHODS OF SURGICAL TREATMENT OF VARICOCELE
https://doi.org/10.24060/2076-3093-2017-7-4-21-26
Abstract
Introduction. Despite the fact that the existence of varicocele in puberty men, may be one of the risk factors of male infertility the mechanism of spermatogenesis breach remains unclear and should be proved further.
Materials and methods. This study conducted a systematic review of randomized researches that are available on PubMed, with the purpose to analyze the optimum choice of surgical techniques to perform varicocelectomy on the basis of the presented results in men suffering from infertility.
Results and discussion. According to the literature data the surgical treatment of varicocele in the presence of clinically significant forms leads to a significant improvement of spermatogenesis after 3-6 months surgical treatment. It is worth noting that the effectiveness of varicocelectomy significantly surpasses the results of drug stimulation of spermatogenesis and dynamic monitoring. At present, therefore it is significant to evaluate efficiency and the choice of the optimal method to surgically treat varicocele. According to the results of meta-analysis, it was concluded that the implementation of microsurgical subinguinal varicocelectomy has a number of advantages compared with such methods as Palomo surgery, laparoscopic varicocelectomy, Ivanissevich surgery and selective embolization of sperm veins.
Conclusion. Application of microsurgical subinguinal varicocelectomy significantly improves quality and quantity parameters of sperm analysis and, consequently, increases probability of spontaneous pregnancy in partners with minimum percentage of complications, as well as of occurrence of relapse in postoperative period.
About the Authors
Oleg I. Apolokhin
Research Institute of Urology and Interventional Radiology N.A. Lopatkin - branch of FSBI NMC of the Ministry of Health of Russia.
Russian Federation
Russian Federation
Apolokhin Oleg Ivanovich - Corresponding member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Adviser of Reproductive Health School, chief freelance specialist of Russian Healthcare in Reproductive Health, Head of Lopatkin N.A. Urology and Interventional Radiology Scientific Research Institute – branch of Federal State Budgetary Institution “National Medical Research Centre” of Russian Healthcare.
3a Parkovaya st., Moscow, 105425.
Evgeniy A. Efremov
Research Institute of Urology and Interventional Radiology N.A. Lopatkin - branch of FSBI NMC of the Ministry of Health of Russia.
Russian Federation
Russian Federation
Efremov Evgeniy Aleksandrovich - Doctor of Medical Sciences, Professor of the Urology, Andrology and Oncourology Department in Additional Professional Education Faculty of Federal State Budgetary Educational Institution of Higher Education “Pirogov N.I. Russian National Research Medical University” of Russian Healthcare, Head of the Andrology and Reproductive Health Department in “Lopatkin N.A. Urology and Interventional Radiology Scientific Research Institute” – branch of Federal State Budgetary Institution “National Medical Research Centre” of Russian Healthcare.
3a Parkovaya st., Moscow, 105425.
Sergey Yu. Shekhovtsov
Pirogov Russian National Research Medical University.
Russian Federation
Russian Federation
Shekhovtsov Sergey Yurevich - Doctor of Medical Sciences, Professor, Head of the Urology, Andrology and Oncourology Department in Additional Professional Education Faculty of Federal State Budgetary Educational Institution of Higher Education “Pirogov N.I. Russian National Research Medical University” of Russian Healthcare, Head of the Scientific Clinical Centre of Open Society Russian Railways.
1 Ostrovityanov st., Moscow, 117997.
Yuriy V. Kastrikin
Pirogov Russian National Research Medical University.
Russian Federation
Russian Federation
Kastrikin Yuriy Vasilevich - Postgraduate at the Urology, Andrology and Oncourology Department in Additional Professional Education Faculty of Federal State Budgetary Educational Institution of Higher Education “Pirogov N.I. Russian National Research Medical University” of Russian Healthcare.
1 Ostrovityanov st., Moscow, 117997.
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Review
For citations:
Apolokhin O.I., Efremov E.A., Shekhovtsov S.Yu., Kastrikin Yu.V. COMPARATIVE ANALYSIS OF METHODS OF SURGICAL TREATMENT OF VARICOCELE. Creative surgery and oncology. 2017;7(4):21-26. (In Russ.) https://doi.org/10.24060/2076-3093-2017-7-4-21-26
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