INTRODUCTION
abdominal wall deformities, postoperative pain, Varicocele, hernia, infertility, pain, fertilityInguinal hernia, tissue damage
VARICOCELE, DISORDERS, PATHOPHYSIOLOGY, CAVITY, VARICOCELE, DILATION, COMPLICATIONS
Varicocele is the dilation of the pampiniform plexus veins and is the main cause of infertility in men, with a prevalence of 35% to 40% in infertile men and 15% to 20% in the general male populationVaricocele has a complex pathophysiology. It is associated with increased testicular venous pressure, ultrastructural changes in spermatic veins, and changes in the synthesis of cytokines and testosteroneThere is a positive association between hernia and varicocele. It is believed that abdominal wall deformities in patients with hernia may cause compression of the testicular veins. Furthermore, enzymatic and biochemical disorders (such as collagen alterations) may promote the development of both diseasesSeveral approaches have been described for varicocele repair: high retroperitoneal, conventional inguinal, inguinal or subinguinal microsurgical, laparoscopic, and radiographic embolizationOne of the most popular approaches to varicocele correction is laparoscopic varicocelectomy. It has a low incidence of complications and results in a significant improvement in symptoms, semen analysis, and fertilityInguinal hernia repair is the most frequently performed procedure in general surgeryOne of the main benefits sought by the new techniques is the reduction of postoperative pain. The microsurgical approach theoretically reduces pain by facilitating the preservation of nerve fibers, but laparoscopy generates less distension and tissue damage, completely avoiding cutaneous innervationOne of the most popular laparoscopic approaches is the transabdominal preperitoneal (TAPP). Recently, a meta-analysis of 8 studiesIn addition, the exposure of the peritoneal cavity that occurs in TAPP hernioplasty allows other simultaneous procedures, such as surgical correction of varicocele.The relationship between multiple procedures in the inguinal region and the possible risks related to testicular perfusion is poorly studiedOur objective is to analyze the feasibility and safety of these procedures in the same surgical time.