AB78. The varicocele anatomy during subinguinal microsurgical varicocelectomy in Chinese men

Introduction and objective: Knowledge of during subinguinal microsurgical varicocelectomy is of fundamental importance to ensure that varicocele is resolved and testicular function is preserved. Our study aimed to describe the number of veins, arteries and lymphatics in the subinguinal spermatic cord and to clarify their differences between two sides, between patients with different complaints and between varicoceles with different clinical grades.

Materials and methods: A total of 102 consecutive patients underwent 162 primary subinguinal microsurgical varicocelectomies, during which the number of vessels with different diameters was recorded.

Results and conclusions: A mean number of 12.9 internal spermatic veins, 0.9 external spermatic veins, 1.8 internal spermatic arteries and 2.9 lymphatics were identified per cord. 88.2% of the internal spermatic arteries were surrounded by a dense complex of adherent veins. The external spermatic vein or veins were found in 49.4% of the cases. The mean number of medium (1-3 mm in diameter) internal spermatic veins on the left was larger than that on the right (P<0.001). The mean number of medium internal spermatic veins in grade III varicocele was larger than that in grade I or grade II (P<0.015). There was no significant anatomic difference between the men presenting for infertility, chronic testicular pain and both the two complaints. The results suggest that differences and correlations exist in the microanatomy of the right and left spermatic cords. Higher clinical varicocele grade may predict the presentation of a greater proportion of larger internal spermatic veins in spermatic cord.

Keywords: varicocele anatomy; subinguinal microsurgical varicocelectomy; subinguinal spermatic cord