Superficial dorsal penile vein thrombosis: a little-known complication of subinguinal varicocelectomy

What's known on the subject? and What does the study add? The superficial dorsal penile vein thrombosis (SDPVT) has been described in connection with different medical and surgical conditions but never in subinguinal varicocelectomy. This study provides the description of a new surgical complication in the subinguinal varicocelectomy: SDPVT. We analysed the pathophisiology and the management of this entity. OBJECTIVE To describe the symptomatology, diagnosis and treatment of superficial thrombosis of the dorsal penile vein - the most common complication of subinguinal varicocelectomy - and analyse the possible mechanisms involved in the development of the condition. PATIENTS AND METHODS The clinical records of 326 patients who underwent varicocele repair during the last 10 years was reviewed. The technique used was subinguinal varicocelectomy with arterial preservation. A mini-Doppler probe was used during surgery for artery identification. We report on the postoperative complications of varicocelectomy, with special attention to superficial dorsal penile vein thrombosis, and provide a detailed description of the anatomy of the superficial venous system of the penis. RESULTS Complications usually associated with varicocele surgery occurred in less than 1% of patients. However, the most common complication in our series was superficial dorsal penile vein thrombosis, which occurred in 2.1% of patients. The use of the mini-Doppler probe allowed us to identify and preserve the arteries in all 326 patients. CONCLUSION Subinguinal varicocelectomy with intra-operative use of a mini-Doppler probe is a rapid and safe technique. The outcomes and complications are similar to those reported for subinguinal microscopic varicocelectomy. Superficial dorsal penile vein thrombosis is a benign self-limited condition whose association with subinguinal varicocelectomy has not been previously reported.