DISCUSSION
postoperative hydrocele, postoperative hematoma, Varicocele, hernia, varicocele
VARICOCELE, DISEASE, COMPLICATION, CAVITY, VARICOCELE, MALE INFERTILITY, DILATION, COMPLICATIONS
Varicocele is a disease characterized by dilation of the pampiniform plexus veins, being the main cause of male infertility. It has a prevalence of 35% to 40% in infertile men and 15% to 20% in the general male populationVaricocele treatment is indicated if it does not improve with conservative treatmentMultiple studies have already demonstrated the safety and efficacy of bilateral laparoscopic varicocelectomy as a therapeutic option for varicoceleInguinal hernia is a tissue protrusion in the inguinal region and can be classified as direct or indirect, depending on its relationship with the epigastric vesselsThe Lichtenstein technique is the most well-established technique for inguinal hernia repair. It is an open repair, with placement of a tension-free meshOne of the most popular laparoscopic approaches is TAPP (Transabdominal Preperitoneal), defined by preperitoneal mesh placement via laparoscopy. Recently, a meta-analysis of 8 studiesIn addition, the exposure of the peritoneal cavity that occurs in TAPP hernioplasty allows the performance of other surgeries through the same access, such as the correction of varicocelePreviously, studies were carried out on simultaneous correction of hernia and varicocele, though investigating other techniques. Chen et. al. followed 40 patients who underwent Bassini herniorrhaphy and microsurgical varicocelectomy and compared them with 20 patients who underwent herniorrhaphy exclusively. In that study, the simultaneous surgery group had only three patients with postoperative hydrocele as a complication, while the other group had no complicationsSchulster et. al. followed 141 patients who underwent microsurgical repair of inguinal hernia and varicocele in the same procedure. Despite the patients not being paired with a control group, the incidence of complications was low (only two patients had postoperative hematoma and one had varicocele recurrence)In our study, probably because we used different techniques from previous work, we observed even fewer complications than those in Chen’sRegarding TOT, previous articles report a significant increase in mean surgical time when surgeries are performed simultaneously, both in Schulster’s study (from 102 vs. 169 minutes) and in Chen’s (38 vs. 70 minutes). In the present study, there was no difference in TOT between groupsThe heterogeneity of surgical techniques in different studies makes it difficult to generalize conclusions, but we can state that simultaneous bilateral laparoscopic varicocelectomy and TAPP hernioplasty can be recommended for patients with hernia and varicocele. Furthermore, despite anecdotal evidence of complications