RESUMO
OBJECTIVES: The management of varicocele in the adolescent continues to be under controversy. Due to its high prevalence some authors support treatment in selected cases only. However, histological changes secondary to its presence have been demonstrated. The objective of this article is to analyze the efficacy, safety, and side effects of spermatic vein ligature by Palomo's technique in adolescents, and to evaluate semen parameters on the long-term. STUDY POPULATION: adolescents with diagnosis of varicocele, grades II and III, confirmed by ultrasound who underwent surgery by the Palomo's technique. DATA ANALYSIS: In patients over the age of 18 willing to participate, semen parameters were studied in 1 or 2 samples depending on results of the first analysis. RESULTS: From 1990, 266 adolescents with the diagnosis of grade II and III varicocele with a mean age of 15 years underwent surgical ligature of the spermatic vein following the technique described by Palomo. Six patients (2.2%) have had varicocele persistence. As a main complication, 23 (8.6%) of them developed left hydrocele requiring surgery. We found no case of testicular atrophy. Twenty-nine patients were available for post operative semen analysis (= 19 years of age) obtaining the following mean values: semen volume: 3.8 cc; overall spermatozoid count: 127 x 10(6); spermatozoa concentration per cc: 37 x 10(6); mobility (grade II+III): 56.6%; morphologically normal spermatozoa: 17%. CONCLUSIONS: Surgical ligature of the spermatic vein by the Palomo's technique is fast, easy, effective, and has scarce side effects. Semen analysis parameters mainly show secondary subfertility or teratozoospermia. We believe that if there is a time for the treatment of asymptomatic varicocele that is puberty.
