CDVL Technique

Varicocele >> CDVL technique

CDVL technique:
Cremasteric Disruption with Venous Ligation

  1. Done under local anaesthesia with all aseptic surgical precautions & monitoring.
  2. Ambulatory Surgery: Patients 'walk in' and 'walk out' of the operating room. No indoor admission. No intra-venous fluids, glucose nor saline
  3. Incision / Cut: Just 1.5 to 2 cm (half inch) long cut Incision site hidden under pubic hair




  4. Cuff of cremasteric muscle is excised.



  5. Only dilated veins are ligated.



  6. Operation time 15 to 20 minutes per side.
  7. Blood loss: Negligible
  8. 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.