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  • Title: Lymphatic preservation using methylene blue dye during varicocele surgery: a single-center retrospective study.
    Author: D'Alessio A, Piro E, Beretta F, Brugnoni M, Marinoni F, Abati L.
    Journal: J Pediatr Urol; 2008 Apr; 4(2):138-40. PubMed ID: 18631910.
    Abstract:
    OBJECTIVE: Hydrocele and testicular edema caused by division of lymphatic vessels during varicocelectomy could lead to decrease in testicular function. In-vivo methylene blue mapping of testicular lymphatic vessels should prevent damage to the lymphatic system. MATERIALS AND METHODS: We retrospectively compared outcomes for 46 patients who received an intraparenchymal injection of 0.25 ml of vital dye (isosulphan blue) before a laparoscopic or an inguinal/subinguinal spermatic vein ligation with 93 controls in whom no mapping technique was adopted. RESULTS: Methylene blue mapping of testicular lymphatics reduced the incidence of postvaricocelectomy hydrocele from 6.4% (6/93) to 2.1% (1/46); the incidence of hydrocele was 0% in all cases of successful lymphatic mapping. CONCLUSION: Mapping of testicular lymphatic drainage with intraparenchymal vital dye is an easy, safe, rapid and cost-free technique. We stress the importance of sparing the lymphatic system to ensure the best andrological outcome.
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