Cremesteric Disruption with Venous Ligation:
Procedure is performed under local anaesthesia with all aseptic surgical precautions & monitoring.
- Ambulatory Surgery: Patients can ‘walk in’ and ‘walk out’ of the operating room. No indoor admission is required. No intra-venous fluids, glucose nor saline is given.
- Incision / Cut : Just 1.5 to 2 cm (half inches) long cut / Incision is made at a site hidden under pubic hair.
- A Cuff of Cremesteric muscle is excised
- Only dilated / pathological veins are ligated.
- Operation time is 15 to 20 minutes per side.
- Blood loss: Negligible
- End result: No recurrence was documented.
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Post Operative:
After the varicocele operation, the patient
- can go home within one hour of surgery.
- may have to take an oral analgesic and antibiotic.
- No patient reported discomfort while travelling.
- They visits the surgeon on the third day after surgery when the dressing is removed.
- He can eat his regular diet.
- Patient can under-take routine activities immediately.
- Office can be resumed from the next day.
- Patient may under-take manual work or undertake long distance travel only after 10 to 15 days.
- He may have sexual intercourse only after 15 to 20 days.
Results:
- Highest success rate with least morbidity were observed.
- Over 1000 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:
High rates (80%) of unassisted pregnancy were achievable with minimum morbidity.
