Recurrence of Varicocele After High Retroperitoneal Repair: Implications of Intraoperative Venography

PURPOSE: We determined whether intraoperative venography results in a decreased recurrence rate after varicocele repair in adolescence. MATERIALS AND METHODS: We evaluated 177 male adolescents 14 to 19 years old who underwent varicocele repair via the high retroperitoneal approach with artery sparing and intraoperative venography. RESULTS: Overall the recurrence rate was 2.8% (5 of 177 cases) in the venography group and 11% in historical controls without venography. We identified left-to-right cross communicating vessels in 3 patients with recurrence. Intraoperatively venography revealed nonligated vessels in 21 patients (12%), resulting in revision and repair during the same procedure. CONCLUSIONS: Intraoperative venography seems to decrease the rate of recurrence. Left-to-right cross communicating vessels may be present in some adolescents with recurrence after varicocelectomy.