Андрология и генитальная хирургия. 2016; 17: 44-48
Оперативный доступ по линии Веслинга при варикоцеле
https://doi.org/10.17650/2070-9781-2016-17-4-44-50Аннотация
Хронология различных методов хирургического лечения варикоцеле не имеет аналогов в урологии по своей емкости. Поиск новых методов оперативного лечения варикоцеле продиктован достаточно частыми рецидивами и послеоперационными осложнениями. Наименее изученными и редко применяемыми являются операции на мошонке при варикоцеле. В настоящей работе мы сделали попытку изучить эффективность оперативного лечения варикоцеле из мошоночного доступа. В настоящей работе представлен самый большой из опубликованных в последнее время материал оперативного лечения варикоцеле из трансскротального доступа. Инновационными в настоящей работе являются: выполнение разреза мошонки по шву (линии Веслинга), ревизия венозных коллекторов яичка и его придатка с определением направления в них кровотока и симультанное проведение пластики оболочек яичка по В. К. Винкельману для предупреждения развития послеоперационного гидроцеле (А. А. Капто). Полученные данные позволяют нам рекомендовать оперативный доступ по линии Веслинга при двустороннем, рецидивном варикоцеле и при сочетанной патологии органов мошонки.
Список литературы
1. Кадыров З. А. Варикоцеле. М., 2006. C. 20. [Kadyrov Z. A. Varicocele. 2006. P. 20. (In Russ.)].
2. Ivanissewich O., Gregorini M. A new operation for cure of varicocele. Sere Med 1918;11:17.
3. Marmar J. L., Debenedicts D. J., Praice D. The management of varicoceles by microdissection of the spermatic cord at the external inguinal ring. Fertil Steril 1985; 43:583.
4. Tauber R., Johnsen N. Antegrade scrotal sclerotherapy for the treatment of varicocele: technique and late results. J Urol 1994;151(2):386–90.
5. Sigmund G., Bahren W., Gall H. et al. Idiopathic varicoceles: feasibility of percutaneous sclerotherapy. Radiology 1987;164(1):161–8.
6. Seyferth W., Jecht E., Zeitler E. Percutaneous sclerotherapy of varicocele. Radiology 1981;139(2): 335–40.
7. Lenk S., Fahlenkamp D., Gliech V., Lindeke A. Comparison of different methods of treating varicocele. J Androl 1994;15 (Suppl): 34–7.
8. Ivanissevich O. Left varicocele due to reflux; experience with 4,470 operative cases in forty-two years. J Int Coll Surg 1960;34:742–55.
9. Palomo A. Radical cure of varicocele by a new technique; preliminary report. J Urol 1949;61:604–7.
10. Goldstein M., Gilbert B. R., Dicker A. P. et al. Microsurgical inguinal varicocelectomy with delivery of the testis: an artery and lymphatic sparing technique. J Urol 1992;148(6):1808– 11.
11. Jungwirth A., Gogus C., Hauser G. et al. Clinical outcome of microsurgical subinguinal varicocelectomy in infertile men. Andrologia 2001;33(2):71–4.
12. Miersch W. D., Schoeneich G., Winter P., Buszello H. Laparoscopic varicocelectomy: indication, technique and surgical results. Br J Urol 1995;76(5):636–8.
13. Tan S. M., Ng F. C., Ravintharan T. et al. Laparoscopic varicocelectomy: technique and results. Br J Urol 1995;75(4):523–8.
14. Jungwirth A., Diemer T., Dohle G. R. et al. Guidelines on Male Infertility. European Association of Urology, 2015. Pp. 18–9.
15. Braz M. P., Martins F., Castagnaro A. et al. Trans-Scrotum “En Bloc” Varicocele Ressection: A New Approach That Prevents Post Operative Hydrocele. Pediatric Urology Fall Congress. September 20–22, 2013. Las Vegas, Nevada. Available at: http://fallcongress.spuonline.org/abstracts/2013/P39. cgi.
16. Zampieri N., Zampieri G., Antonello L., Camoglio F. S. Trans-scrotal varicocelectomy in adolescents: Clinical and surgical outcomes. J Pediatr Surg 2014;49:583–5.
17. Iacono F., Ruffo A., Prezioso D. et al. Treatment of bilateral varicocele and other scrotal comorbidities using a single scrotal access: our experience on 34 patients. Biomed Res Int 2014;2014:403603. DOI: 10.1155/2014/403603.
Andrology and Genital Surgery. 2016; 17: 44-48
Surgery for varicocele through Vesling line
https://doi.org/10.17650/2070-9781-2016-17-4-44-50Abstract
Chronology of the surgical treatments of varicocele is unique in its capacity for urology. The search for new methods of surgical treatment of varicocele is dictated quite frequent relapses and postoperative complications. The least studied and rarely used operations are on the scrotum varicocele. In this paper we have attempted to study the effectiveness of surgical treatment of varicocele throughscrotal access. In this paper we present the largest of the recently published material surgical treatment of varicocele through scrotal access. Innovative in this work are: the implementation of scrotal incision at the raphe scroti (Vesling line), revision of the venous reservoir testis and epididymis with the definition of the direction in which the blood flow and a simultaneous holding plastic testis shells by W. К. Winkelmann for the prevention of postoperative hydrocele (A.A. Kapto). The obtained data allows us to recommend operative access through Vesling line for treatment of the bilateral, recurrent varicocele and comorbidity of scrotum.
References
1. Kadyrov Z. A. Varikotsele. M., 2006. C. 20. [Kadyrov Z. A. Varicocele. 2006. P. 20. (In Russ.)].
2. Ivanissewich O., Gregorini M. A new operation for cure of varicocele. Sere Med 1918;11:17.
3. Marmar J. L., Debenedicts D. J., Praice D. The management of varicoceles by microdissection of the spermatic cord at the external inguinal ring. Fertil Steril 1985; 43:583.
4. Tauber R., Johnsen N. Antegrade scrotal sclerotherapy for the treatment of varicocele: technique and late results. J Urol 1994;151(2):386–90.
5. Sigmund G., Bahren W., Gall H. et al. Idiopathic varicoceles: feasibility of percutaneous sclerotherapy. Radiology 1987;164(1):161–8.
6. Seyferth W., Jecht E., Zeitler E. Percutaneous sclerotherapy of varicocele. Radiology 1981;139(2): 335–40.
7. Lenk S., Fahlenkamp D., Gliech V., Lindeke A. Comparison of different methods of treating varicocele. J Androl 1994;15 (Suppl): 34–7.
8. Ivanissevich O. Left varicocele due to reflux; experience with 4,470 operative cases in forty-two years. J Int Coll Surg 1960;34:742–55.
9. Palomo A. Radical cure of varicocele by a new technique; preliminary report. J Urol 1949;61:604–7.
10. Goldstein M., Gilbert B. R., Dicker A. P. et al. Microsurgical inguinal varicocelectomy with delivery of the testis: an artery and lymphatic sparing technique. J Urol 1992;148(6):1808– 11.
11. Jungwirth A., Gogus C., Hauser G. et al. Clinical outcome of microsurgical subinguinal varicocelectomy in infertile men. Andrologia 2001;33(2):71–4.
12. Miersch W. D., Schoeneich G., Winter P., Buszello H. Laparoscopic varicocelectomy: indication, technique and surgical results. Br J Urol 1995;76(5):636–8.
13. Tan S. M., Ng F. C., Ravintharan T. et al. Laparoscopic varicocelectomy: technique and results. Br J Urol 1995;75(4):523–8.
14. Jungwirth A., Diemer T., Dohle G. R. et al. Guidelines on Male Infertility. European Association of Urology, 2015. Pp. 18–9.
15. Braz M. P., Martins F., Castagnaro A. et al. Trans-Scrotum “En Bloc” Varicocele Ressection: A New Approach That Prevents Post Operative Hydrocele. Pediatric Urology Fall Congress. September 20–22, 2013. Las Vegas, Nevada. Available at: http://fallcongress.spuonline.org/abstracts/2013/P39. cgi.
16. Zampieri N., Zampieri G., Antonello L., Camoglio F. S. Trans-scrotal varicocelectomy in adolescents: Clinical and surgical outcomes. J Pediatr Surg 2014;49:583–5.
17. Iacono F., Ruffo A., Prezioso D. et al. Treatment of bilateral varicocele and other scrotal comorbidities using a single scrotal access: our experience on 34 patients. Biomed Res Int 2014;2014:403603. DOI: 10.1155/2014/403603.
