Editing Varicocele (section)

====== Retroperitoneal ======
* '''Involves incision at the level of the internal inguinal ring, splitting of the external and internal oblique muscles, and exposure of the gonadal/internal spermatic artery and vein retroperitoneally near the ureter.'''
* '''Still a commonly used method for the repair of varicocele, especially in children.'''
* '''Advantages:'''
** '''Involves ligation of the fewest number of veins'''
*** This approach isolates the gonadal/internal spermatic veins proximally, near the point of drainage into the left renal vein. At this level, only 1-2 large veins are present, and in addition the testicular artery has not yet branched and is often distinctly separate from the internal spermatic veins.
**** Despite the above statement, CW11 Table 25-5 suggests that the artery is not preserved with retroperitoneal approach
* '''Disadvantages:'''
** '''High incidence of varicocele recurrence and hydrocele formation'''