Comparison of therapeutic effect between microsurgical varicocelectomy and conventional methods in the treatment of primary varicocele

Abstract:

Objective：To compare the therapeutic effect of three kinds of surgical treatments for primary varicocele． Methods：Ninety-seven patients with primary varicocele were randomly divided into three groups according to the operative methods：38 cases with high ligation of varicocele through an inguinal incision（open surgery group），33 cases with laparoscopic varicocelectomy（laparoscope group），26 cases with microsurgical varicocelectomy（microsurgery group）. All cases were followed up for 12 months. Therapeutic effects and complications of three groups were compared and analyzed． Results：All operations in three groups were completed successfully． There were significant differences in operating time among three groups（56.02±4.84 vs. 35.60±4.54 vs. 91.65±4.56，F=1 058.74，P=0.000）. There were significant differences in the identification rates of testis artery among three groups（52.63% vs. 54.55%，P=0.872；54.55% vs. 100%，P=0.000；52.63% vs. 100%，P=0.000）. There were significant differences in the improved quality of semen after the operation among three groups（34.21% vs. 33.33%，P=0.938；33.33% vs. 65.38%，P=0.014；34.21% vs. 65.38%，P=0.014）. There were significant differences in pain score of incision after the operation among three groups（7.45±0.65 vs. 4.82±0.58 vs. 1.04±0.34，F=1 018.35，P=0.000）. There were significant differences in the incidences of testicular hydrocele after the operation among three groups（26.32% vs. 21.21%，P=0.615；21.21% vs. 0.00%，P=0.014；26.32% vs. 0.00%，P=0.013）. There were significant difference in recurrence rate of varicocele after the operation among three groups（28.95% vs. 21.21%，P=0.455；21.21% vs. 0.00%，P=0.014；28.95% vs. 0.00%，P=0.007）. There were significant difference in the postoperative hospitalization duration among three groups（7.26±0.79 vs. 5.45±0.75 vs. 3.65±0.63，F=186.10，P=0.000）. Conclusion：With the advantages of higher identification rates of testis artery，satisfied efficacy，fewer complications and shorter hospitalization duration，microsurgical varicocelectomy is worth of clinical application expect longer operation time.