Complications
Can occur following percutaneous embolization, but relatively uncommon.
Can occur as a result of untreated varicocele or postsurgical complication. Damage to the testicular artery intraoperatively may result in testicular atrophy. Can occur with any surgical approach.
Unclear etiology; thought to be secondary to lymphatic obstruction.
Incidence of hydrocele varies with procedure: microscopic inguinal or subinguinal surgery (0.4%); laparoscopic surgery (2.8%); inguinal surgery (7.3%); open retroperitoneal high ligation (8.2%).[51][71]
In children and adolescents, incidence of postoperative hydrocele varied between 0.8% and 11.4%, with higher rates reported with laparoscopic mass-ligation/division and lower rates for laparoscopic lymph-sparing surgery and embolization and sclerotherapy techniques.[52]
Most can be safely observed and regress without treatment; some will respond to simple puncture, although if further recurrence is symptomatic, open repair may be indicated.[72]
Usually, hydrocele forms anywhere from 6 months to 3 years post-procedure.[73] Long-term follow-up is needed to document true incidence.
Usually occurs as a result of missing veins during primary surgery; recurrence is higher if an artery-sparing technique is used.[74][75]
Incidence of recurrence varies with procedure: microscopic inguinal or subinguinal surgery (1.1%); laparoscopic surgery (4.3%); inguinal surgery (2.6%); open retroperitoneal high ligation (15.0%); embolization (12.7%).[51][71]
Can take up to 6 months to see resolution of varicocele depending on technique chosen.
A possibility with transperitoneal laparoscopic approach, or with other approaches in the presence of an unexpected hernia.
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