Varicocele is not an uncommon condition in pre-adolescence. Internal spermatic vein phlebography provides insight into vascular anatomy and etiopathogenesis. Eighty-six cases treated by microsurgical spermatico-epigastric anastomosis (Belgrano technique) are reported. This technique has been shown to achieve a very high cure rate (98.8%). Several techniques of venous anastomosis are described and compared with the Belgrano technique. The results show that the latter is the ideal technique because it not only resolves reflux but also provides adequate venous drainage to the testis.
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