TREATMENT AND DIAGNOSTIC ALGORITHM FOR MANAGING PATIENTS WITH VARICOCELE
Keywords:
varicocele, diagnosis, treatment, Ivanisevich’s operation, Palomo’s operation, Marmara’s operation, antegrade endovascular sclerotherapy, complication.Abstract
to improve the results of surgical treatment of various types of pathological varicocele reflux. Material
and methods: Under the supervision, there were 376 patients with left-sided varicocele who were admitted to the urology
department of the 2nd clinic of SamSMI, which were divided into 2 groups. In 2005-2010 181 (48.1%) patients underwent
conventional surgical interventions (Ivanisevich or Palomo operations). In 2011-2018 195 (51.9%) patients underwent
subingual selective surgeries (antegrade endovascular sclerotherapy of the left testicular vein and Marmara surgery).
Results: Doppler scanning of testicular veins makes it possible to determine the degree of vascularization of the scrotum
organs, which makes it possible to most accurately together with ultrasound data in B-mode make an accurate diagnosis
and choose the appropriate treatment tactics. The cause of recurrence of varicocele was unaccounted for during the primary
operation of various hemodynamic types of venous outflow through the internal spermatic vein. The prospect of improving
the results of surgical treatment of varicose veins of the spermatic cord is the individualization of the method of operation,
taking into account the type of pathological reflux. Conclusions: thanks to the implementation of the developed treatment
and diagnostic algorithm for managing patients with varicocele, the number of complications and relapses was reduced to
2.6 and 1.6%, respectively (with generally accepted traditional methods of operations – 12.7 and 17.1%).
