Special Surgical Procedures II
LESSON 3: Procedures in Genitourinary Surgery
Section v: operations on the scrotum, penis, and urethra
3-35
3-35. VARICOCELECTOMY
a. General. This procedure involves ligation and partial excision of dilated veins in the scrotum. It is done to reduce congestion of the testes and to improve spermatogenic function. The condition occurs more frequently on the left, since the vein of the left testis is connected to the renal vein and is under greater pressure. The veins of the pampiniform plexus of the spermatic cord become tortuous and engorged, causing a bag of redundant veins.
b. Operative Procedure.
(1) The incision may be made low in the inguinal canal or in the upper portion of the scrotum. The structures of the spermatic cord are identified and the vessels dissected free from the vas deferens.
(2) The abnormal vessels in the inguinal canal are clamped and ligated. The redundant portions are excised. The remaining structures are sutured to the external oblique fascia above the external inguinal ring to support the testicle.
(3) A Penrose drain may be placed. The incision is closed in layers.
