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Varicocele
-> CDVL technique
CDVL
technique:
Cremasteric Disruption with Venous Ligation
- Done
under local anaesthesia with all aseptic surgical precautions
& monitoring.
- Ambulatory
Surgery: Patients 'walk in' and 'walk out' of the operating room.
No indoor admission. No intra-venous fluids, glucose nor saline
- Incision
/ Cut: Just 1.5 to 2 cm (half inch) long cut Incision site hidden
under pubic hair
- Cuff of
cremasteric muscle is excised.
- Only dilated
veins are ligated.
- Operation
time 15 to 20 minutes per side.
- Blood loss:
Negligible
- End result:
No recurrence
documented.
post operative
After the
varicocele operation, the patient
- goes home
within one hour of surgery.
- may have
to take an oral analgesic and antibiotic.
- reported
no discomfort while travelling.
- visits the
surgeon on the third day after surgery when the dressing is removed.
- can eat
his regular diet.
- can perform
routine activities immediately.
- can resume
office on the next day.
- may perform
manual work or undertake long distance travel only after 10 to
15 days.
- may have
sexual intercourse only after 15 to 20 days.
results
- Highest
success with least morbidity.
- Over 500
Varicocele patients underwent cremasteric disruption with venous
ligation.
- Semen improvement
in almost all (97%) patients.
- One-year
pregnancy rate: 64%
Two year pregnancy rate: 80%
- Minimal
morbidity,
- Transient
discomfort,
- No blood
loss
in
conclusion
Varicocelectomy
by outpatient sub-inguinal cremasteric disruption & venous ligation
is a physiological, economical and safe option.
High rates
(80%) of unassisted pregnancy were achievable with minimum morbidity.
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