RESULTS OF SURGICAL TREATMENT OF VARICOCELE

According to the WHO, varicocele is the cause of infertility in 9-40% of patients. The prevalence of varicocele among children and adolescents aged 10-18 years reaches 19%. Early detection of varicocele can correct impaired fertility and maintain reproductive function in childbearing age. The existing methods of surgical treatment do not in all cases relieve the patient of infertility and cannot guarantee the recurrence of the disease. The aim of the study was to improve the results of diagnosis and surgical treatment of varicocele in children. This work is based on the results of treatment of 376 patients with left-sided varicocele. Of 376 patients, 363 (96.5%) patients had varicocele for the first time and 13 (3.5%) patients had a relapse. The patients were between the ages of 11 and 18. Depending on the method of surgery, 2 groups of patients were identified. 181 (48.1%) patients underwent conventional surgical interventions (Ivanissevich's or Polomo's operations), which made up the comparison group. 195 (51.9%) patients underwent subinguinal selective operations (antegrade endovascular sclerotherapy of the left testicular vein and Marmara operation), which were included in the main group. Selected 26 practically (control group) healthy children data of ultrasound and Doppler ultrasound of the testicular veins, we took as the norm. During the surgical treatment of varicocele, an individual, differentiated approach was chosen for each patient depending on the hemodynamic type. The analysis of the surgical treatment of patients with varicocele revealed a relapse of the disease in 15% of cases. The developed methods of treatment, taking into account the type of blood flow, are low-traumatic and exclude the possibility of recurrence. The proposed methods of surgical treatment of varicocele have reduced the number of complications from 24.8% to 2.3%.

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