The effect of testicular artery preservation on the results of preventive and curative varicocelectomy
For citation:
Shidaev A. Kh-A.,Sizonov V.V., PirogovA.V., Ikaev M.V.,Ikaeva I.M. The effect of testicular arterypreservation on the results of preventive and curative varicocelectomy. Pediatric Urology-Andrology 2025;1(1):11-17.
Shidaev A. Kh-A., Sizonov V.V., Pirogov A.V., Ikaev M.V., Ikaeva I.M.
Information about authors:
- Shidaev A.Kh.-A. – PhD, Head of the Pediatric Urology and Andrology Division, Republican Children’s Clinical Hospital, Vladikavkaz, Russian Federation; RSCI Author ID 1047966, https://orcid.org/0000-0002-8634-6453
- Sizonov V.V. – Dr. Sci., Professor at the Department of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University; Deputy Chief Physician for Surgery, Rostov-on-Don Regional Children’s Hospital, Rostov-on- Don, Russian Federation; RSCI Author ID 654328, https://orcid.org/0000-0001-9145-8671
- Pirogov A.V. – PhD, Head of the Pediatric Urology and Andrology Division, Rostov-on-Don Regional Children’s Hospital, Rostov-on-Don, Russian Federation; RSCI Author ID 1235940, https://orcid.org/0000-0001-8031-2597
- Ikaev M.V. – M.D. pediatric urology, pediatric surgeon, Vladikavkaz Republican Children's Clinical Hospital. Vladikavkaz, Russian Federation, https://orcid.org/0009-0006-9948-7374
- Ikaeva I. M. – student of First Moscow State Medical University, Moscow, Russian Federation; https://orcid.org/0009-0009-5009-8628
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Introduction. The debate regarding the value of extending surgery and the potential increase in postoperative varicocele recurrence when performing artery-preserving techniques has been ongoing for many years. Notably, the 2024 clinical guidelines of the European Society for Paediatric Urology (ESPU) also provide conflicting recommendations on whether the testicular artery should be preserved during varicocelectomy
Objective. This article presents a literature review examining the role of the testicular artery in varicocelectomy for adolescents and its potential impact on male reproductive outcomes.
Materials and Methods. According to the literature, the key outcome measures used to evaluate the role of the testicular artery include pregnancy rates, semen parameters, postoperative testicular volume, recurrence rates, and changes in testicular haemodynamics. Most available studies, however, have been conducted in adults.
Results. In adolescents, reproductive potential is realised only after an undefined interval, unlike in adults, which makes it impossible to assess the impact of artery-preserving versus artery-ligating varicocelectomy on fertility outcomes in this age group. The current evidence demonstrates a lack of studies comparing testicular haemodynamics after artery-preserving and artery-ligating varicocelectomy in adolescents, as well as the absence of standardised criteria for evaluating surgical success.
Conclusions. These gaps highlight the need for well-designed studies focused specifically on adolescents.
Keywords:
varicocele; varicocelectomy success; testicular artery; adolescents
