Comparison of Two Methods in Surgical Treatment of Varicocele: Laparascopic and Open Surgery

Abstract

Introduction and Objective: Varicocele is the loosening of testicular veins and the pump form venous channel within the spermatic cord. There are different treatments for varicocele, as open surgery, microsurgery, laparoscopy, sclerotherapy and other techniques. The purpose of this study was to compare the outcomes of laparoscopic and open techniques in the surgical treatment of varicocele. Materials and Methods: In a randomized interventional study, 96 patients referring to the private or public hospitals of Hamedan were diagnosed to have Varicocele, and after filling the informed consent they were included in the study.  Patients with a confirmed diagnosis of Varicocele, were studied after filling the testimonial. Testicles size was measured by using vernie calipers in width and height and the patients underwent the analyzing of their semen fluid. The patients were randomly assigned into 2 groups (n = 48 per group). Following-up the patients in order to assess any effects related to the treatment, such as wound infection, hydrocele, hematoma, and etc. lasted up to 1 month. Examining with regard to the recurrence or lack of examination of the form obvious clinical Varicocele was conducted, despite the treatment and related examines with infertility factors after 6 months. The assessment of the size of the testis and analysis of semen was done after 3 and 6 months. At the end of 6 months, the results were compared between the two groups. The collected data was analyzed using the indicators of frequency, mean, SD and in necessary cases were analyzed using t-test and paired t-test, and in cases of comparing qualitative data it was analyzed by using Chi-square test. The significance of the results were considered P ≤ 0.05. Results: The semen analysis after 6 months, in all patients, indicated a significant difference in favor of the improvement of these factors after the surgery, in comparison with to the state before the surgery. These evaluations were performed separately in each group and in both laparoscopic and open groups a statistically significant difference was observed in favor of improving semen analysis factors. Changes in these factors before and after the surgery were compared in both groups and no significant statistical difference was observed. This means that both groups had no differences regarding the effect on fertility factors. No varicocele recurrence was reported within 6 months. Hospital stay was had no significant differences between the two groups. Also, no significant difference was observed between the two groups, regarding the effects associated with surgery. Conclusions: Open and laparoscopic varicocelectomy surgeries have approximately equal post-surgery consequences, regarding improved parameters of semen liquid and post-surgery effects. However, further research with larger sample size and longer follow-up period is required so that with greater certainty, we could judge about the advantages and disadvantages of the two methods.