Microsurgical operation Marmara is one of thetypes of surgery for the treatment of an ailment, called varicocele. It is prescribed by a urologist when there is an expansion of the veins of the thorny plexus of the testicle (varicocele), when the patient complains of discomfort in the scrotum, or when the size of the testicle decreases, its function decreases.
Advantages of Marmara surgery before other methods of combating varicocele
Operation Marmara every year more and more doctors is recognized as the most effective and reliable method of therapy for varicocele. The main advantages are:
- in the least number of relapses, which is made possible by microsurgical glasses and a microscope, which allow to process the smallest veins;
- in a small degree of traumatization of tissues;
- in a small and inconspicuous scar not larger than 2 cm;
- in almost complete absence of pain syndrome after surgery;
- in improving the quality and quantity of sperm;
- the ability to quickly return the patient to a normal lifestyle.
A few more differences between the operational methods forIvanissevich, or laporskopii, from the method of Marmar. Operation according to Ivanissevich suggests dissection of the aponeurosis, which can lead to traumatization of the muscles of the anterior abdominal wall, increasing the rehabilitation period and strengthening the postoperative pain syndrome. Operation on Marmara allows you to cope with both left-sided and right-sided varicocele. And improvement of spermatogenesis and evaluation of fertility can be carried out after 6-9 months. Most men after the intervention on Marmara in the next few years have the opportunity to become fathers.
What are the indications for the appointment of the Marmara operation
The main and, in general, the only indication,when the Marmara surgery is prescribed, it is considered varicocele - a disease that can occur without significant clinical manifestations, almost asymptomatic.
But often, seeking help from specialists,patients complain of heaviness in the scrotal area, pain in the testicle. When the examination reveals abnormalities in the spermogram, which indicates a violation of sperm production testicles. Non-surgical treatment of the disease is impossible, especially if it comes to complications that can lead to infertility. Operation Marmara with varicocele, according to world statistics, allows you to fully restore the genital function of the organ.
Varikotsele: what is it, what is fraught with
The disease involves the expansion of the veins of the testiclesSeed cord, which is associated with a violation of the operation of check valves located in the veins. That is, a healthy valve ensures blood flow through the vein in only one direction, damages in the valves prevent them from holding back the outflow of blood. Any increase in pressure leads to the fact that the blood tends back.
Causes of the disease
Varicocele can be a manifestation of:
- congenital malformation of venous valves;
- congenital weakness of the vascular wall;
- increased pressure in the small pelvis or scrotum, which leads to bending, changing the shape and gradual squeezing of the veins.
To correct this pathology, there are manyvarious methods, for example, operation on Ivanissevichu or laparoscopic method. Why became popular method Marmar? The operation practically excludes the possibility of damage to the muscles of the abdominal wall, damage to the arteries of the testicle, and inflammation.
Contraindications to the operation of Marmara
As with any surgical intervention, even the most effective and safe procedure may have contraindications:
- stage of exacerbation in chronic pathologies of internal organs;
- the first six months after a stroke, a heart attack or other ischemic heart diseases;
- inflammatory processes in the genitourinary system;
- influenza, acute respiratory infections and other infectious diseases.
How to Prepare for Intervention
The operation of Marmara and the preparation for it impliesConducting a standard scope of research: general, clinical and biochemical blood test, coagulogram, ECG, RW, syphilis, HIV, hepatitis, anesthesia examination on the eve of surgery.
Preoperative examination can be expanded or, conversely, reduced depending on the scope of planned intervention, age and general condition of the patient.
Immediately before the operation follows:
- Shave off hair, if any, in the upcoming area of operation. This should be done carefully, without cuts on the skin and the appearance of further irritation.
- Some doctors practice the appointmentanti-inflammatory or antibacterial therapy, which reduces the risk of inflammation in the invasive area. Reception of preparations begins for some days prior to operation.
- General anesthesia or spinal anesthesiaassumes the last meal not later than 10 pm. The day before the operation is not allowed to eat, drink, smoke. In the evening on the eve of surgery and on the morning of the day of surgery, a cleansing enema is made.
- Local anesthesia does not require fasting or cleansing enema.
- Прием антикоагулянтов следует прекратить за 5 days before the forthcoming operation. Instead, low-molecular-weight heparin preparations are prescribed, which reduces the risk of surgical or post-operative bleeding.
Operation Marmara at varikotsele, reviews about whichtestify to the high effectiveness of the method, it allows to restore the venous current and prevent the outflow of blood poisoning the testicles. Postoperative relapse occurs in only 5-7% of patients.
Types of anesthesia: what can be, what is more preferable
Marmara surgery can be performed under general anesthesia, which, like the other types, is performed by an anesthesiologist, while the patient falls asleep and wakes up after the operation is over.
Spinal anesthesia anesthetizes the entire lower half of the body. The injection is made in the area of the spinal column.
Local anesthesia will anesthetize only the invasive site, while the patient will be conscious, but the pain will not be felt. In recent years, more and more doctors prefer the local type of anesthesia.
How is surgery performed?
The operation begins with the fact that the surgeon dissectsskin of the sub-brazed area, making a cut in the size of 1.5 - 2 cm. There is a seminal cord, which for convenience is excreted into the wound. With the help of a microscope, the surgeon secretes the testicular veins and binds them. Doctors prefer to use local anesthesia, because the patient can be asked to breathe and strain, which allows the doctor to better see everything, even the smallest, enlarged veins and venous twigs. The microscope allows to make the process of ligation as correct as possible, without traumas of nearby nerves, lymphatic vessels and arteries. After suturing all the veins on the wound, the drainage is made by a rubber graduate. Then an aseptic bandage is applied to the incision site.
Surgical intervention lasts for30-40 minutes. After that the patient is transported to the postoperative ward, where he remains for several hours under the supervision of a doctor. After two hours, having evaluated the patient's condition, the doctor can let him go home.
Postoperative period
The period of rehabilitation after surgery Marmaraminimum. It will be necessary to arrive at the dressing only a few times if it is not possible to carry out the procedure at home. Already after a few days, the patient can fully return to his usual lifestyle. True, it is recommended to refrain from sexual relations, from lifting and carrying weights and playing sports so that the integrity of the seams is not violated. This is confirmed by patient reviews. Stitches are removed after 7-8 days. A small scar will be located below the line of wearing lingerie, in the area where the hair grows, so that it remains invisible. The operation of Marmara, reviews of which are extremely positive from both patients and doctors, does not cause testicular atrophy, no dropsy, or any other complications that can be expected from other types of surgery. This operation allows you to restore and prevent further expansion of the veins, to improve the quality of sperm.
According to many men, the operation Marmara is a quick and effective method of getting rid of varicocele, which allowed them to avoid postoperative complications, pain, discomfort and ugly scars.
