Abstract
Background and Objectives: One of the important problems in the operational procedures of varicocele through inguinal and subinguinal is the preservation of spermatic artery. In this study, we compared the efficacy of vasodilatators on spermatic artery.
Materials and Methods: From 2000 to 2002, all patients with varicocele who admitted in the hospital and candidated for operation were selected. In 85 patients‚ 95 microscopic subinguinal varicocelectomy were performed. In patients whose arteries had not pulsatile or contracted during operation, verapamil, nitroglycerine or papverine were used respectively, while the surgeon was not informed about the type of drug used. Then results compared with each other.
Results: In 30 cases out of 90, enough arterial pulse was existed and did not need for drug use. In 19 cases, the artery was contracted and needed to use a drug in which verapamil had the best results (87.5%). In 56 cases arterial pulsation was not seen and drug was applicated. Verapamil worked more rapid than other two drugs and the difference was significant statistically (with nitroglycerin P=0.0282 and with papaverine P=0.0001). Generally, verapamil in 90.9 percents was effective in exposing of spermatic artery. Only one case with arterial injury was observed that who not responded to drug. In post-surgical follow up only one case had hydrocele and three cases had recurrence of varicocele.
Conclusion: Considering the appropriate effects of verapamil on the exposure of spermatic artery, we recommend verapamil routinely to be used during microscopic varicocelectomy.