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An Analysis of Major Causes of Surgical Failure Using Bähren System in Intraoperative Venography During Varicocelectomy

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dc.date.accessioned2021-11-19T01:37:22Z-
dc.date.available2021-11-19T01:37:22Z-
dc.date.issued2021-10-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/185948-
dc.description.abstractPurpose: In young patients with varicocele, preservation of the internal spermatic artery may be advantageous for catch-up growth, but it may also increase the likelihood of treatment failure. Intraoperative venography reduces the likelihood that unsealed veins will remain after varicocelectomy. We analyzed the characteristics of remnant veins visualized through intraoperative venography to investigate the cause of surgical failure in artery-sparing varicocelectomy (ASV). Materials and methods: We retrospectively analyzed clinical characteristics and outcomes of patients aged 18 years or younger who underwent varicocelectomy with intraoperative venography from January 2005 to December 2017. During varicocelectomy, intraoperative venography was performed to distinguish veins from other structures. Any unsealed veins that were discovered were ligated and classified using the Bahren system. Results: One hundred and sixty-two patients underwent intraoperative venography: 153 cases (94.4%) were for primary varicocelectomy, and 9 cases (5.6%) were for repeat varicocelectomy. Open varicocelectomy was performed in 105 cases (64.8%), and laparoscopic varicocelectomy was performed in 57 cases (35.2%). Venography revealed remnant veins after the first ligation in 51 cases (31.2%), 46 (90.2%) and 5 (9.8%) of which were Bähren types 3 and 4, respectively. Five patients (3.1%) experienced varicocele recurrence, classified as persistence in 1 patient (0.6%) and relapse in 4 patients (2.5%). Conclusion: Remnant collateral veins of the internal spermatic vein (ISV) (Bahren type 3) are the most common cause of failure in ASV. In a few patients, an external spermatic vein merges with the ISV at a higher level (Bahren type 4) and is unidentifiable without venography.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherYonsei University-
dc.relation.isPartOfYONSEI MEDICAL JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHPhlebography-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSpermatic Cord* / diagnostic imaging-
dc.subject.MESHSpermatic Cord* / surgery-
dc.subject.MESHTestis-
dc.subject.MESHVaricocele* / diagnostic imaging-
dc.subject.MESHVaricocele* / surgery-
dc.subject.MESHVeins / diagnostic imaging-
dc.subject.MESHVeins / surgery-
dc.titleAn Analysis of Major Causes of Surgical Failure Using Bähren System in Intraoperative Venography During Varicocelectomy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Urology (비뇨의학교실)-
dc.contributor.googleauthorKyung Tak Oh-
dc.contributor.googleauthorSang Woon Kim-
dc.contributor.googleauthorSung Ku Kang-
dc.contributor.googleauthorSung Hoon Kim-
dc.contributor.googleauthorCho Nyeong Lee-
dc.contributor.googleauthorSang Won Han-
dc.contributor.googleauthorYong Seung Lee-
dc.identifier.doi10.3349/ymj.2021.62.10.928-
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dc.relation.journalcodeJ02813-
dc.identifier.eissn1976-2437-
dc.identifier.pmid34558872-
dc.subject.keywordVaricocele-
dc.subject.keywordlaparoscopes-
dc.subject.keywordphlebography-
dc.contributor.alternativeNameKang, Sung Ku-
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dc.citation.volume62-
dc.citation.number10-
dc.citation.startPage928-
dc.citation.endPage935-
dc.identifier.bibliographicCitationYONSEI MEDICAL JOURNAL, Vol.62(10) : 928-935, 2021-10-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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