[Choice of surgical correction of varicocele based on the characteristics of venous hemodynamics].

A complex ultrasound investigation of the left renal, testicular veins, those of the pampiniform plexus and intraoperative analysis of varicose venous truncks specify hemodynamic aspects of varicocele genesis, identify a group of patients with suspected regional venous renal hypertension and help to decide on surgical policy. Hemodynamic disorders leading to varicocele can be corrected with consideration of regional venous renal hypertension by surgical interventions with creation of testiculo-inferio-epigastric, testiculo-inferio-epigastric superficial and testiculosafic anastomoses and their combinations. Valid are microsurgical corrections of types I and II according to Coolsaet disorders of venous hemodynamics in varicocele using non-varicose testicular veins. In the presence of type III and/or signs of venous renal hypertension, combinations of venous anastomoses are practiced. The results of duplex angioscanning of the region of anastomoses and analysis of male fertility evidence for positive early and late outcomes of microsurgical treatment of varicocele.