Retroperitoneal high ligation versus subinguinal varicocelectomy: Effectiveness of two different varicocelectomy techniques on the treatment of painful varicocele

Abstract

In the present study, we compared the retroperitoneal high ligation with subinguinal varicocelectomy on the treatment of painful varicocele. A total of 90 patients who underwent retroperitoneal high ligation (n = 45) and subinguinal varicocelectomy (n = 45) for painful varicocele were included in this prospective study. Varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography. All the patients underwent a conservative treatment for pain for 4 weeks. Patient ages, varicocele grades, preoperative pain scores, postoperative pain scores at 6 months, duration of surgeries, complications and recurrences were recorded. Complete success rate for chronic scrotal pain was found to be 80% in retroperitoneal varicocelectomy group and 71% in subinguinal varicocelectomy group. Partial success rate was 11% for retroperitoneal varicocelectomy group and 18% for subinguinal ligation group. There was no significant difference between two groups in terms of pain and complications. However, the operation time was significantly lower in the Palomo group. Although microsurgical subinguinal varicocelectomy is the current approach for the treatment of varicocele, retroperitoneal high ligation can achieve the same pain resolution with shorter operative duration compared to loupe‐assisted subinguinal varicocelectomy.

Improvement of sperm morphology after surgical varicocele repair

“…In our cohort, seminal improvement is detected only in patients treated with sub‐inguinal flebectomy. This is contrast with previous studies highlighting a substantial overlap among surgical procedures 43–45 . However, our results could be due to the predominance of patients treated with the sub‐inguinal surgical access (76% of the series).…”

“…This is contrast with previous studies highlighting a substantial overlap among surgical procedures. 43 , 44 , 45 However, our results could be due to the predominance of patients treated with the sub‐inguinal surgical access (76% of the series). The surgical procedure presented a relapse rate of 12.4% (15 cases on 121) in our casuistry, independently of the technique applied.…”

Improvement of Sperm Morphology After Surgical Varicocele Repair

“…In our cohort, seminal improvement is detected only in patients treated with sub-inguinal ebectomy. This is contrast with previous studies highlighting a substantial overlap among surgical procedures [40][41][42] . However, our results could be due to the predominance of patients treated with the sub-inguinal surgical access (76% of the series).…”

Evaluation of the Relationship Between Body Mass Index (BMI) and DNA Fragmentation Index Changes in Primary Infertile Patients Following Microscopic Sub Inguinal Varicocelectomy

“…Varicocele is the most common cause of infertility (1), which is defined as the abnormal dilation of the pampiniform plexus veins (2), and is considered as one of the known causes of infertility. 10% to 15% of the general population has a varicocele, as well as 30% to 35% of people with primary infertility and 69% to 81% of people with secondary infertility (3).…”