A Comparative Study of Subinguinal Microscopic versus Open Surgical Varicocelectomy in Treatment of Primary Varicocele

Abstract Purpose To compare the outcome between microscopic and conventional subinguinal varicocelectomy regarding improvement in semen quality and pain resolution in patients who complain of varicocele-related infertility, pain, or both. Patients and Methods A prospective interventional non randomized controlled trial was carried out on 64 patients who met the criteria and allocated to two groups, group A (n = 34) underwent microscopic sub inguinal varicocelectomy, and group B (n = 30) underwent conventional sub inguinal varicocelectomy. A 3-month postoperative semen analysis was compared to the preoperative one, and pain was assessed preoperatively, 1 month and 3 months postoperatively. Results Both study groups showed significant improvement in the semen quality. Moreover, improvement in semen parameters was significantly higher in group A when compared to group B. Improvement in sperm concentration was 89.2 % and 41.7%, and in progressive motility was 100% and 50% for group A and B, respectively (P < 0.01). At 1 month and 3 months postoperatively, pain score was significantly lower in group A (Median = 0 & 0, respectively) in contrast to group B (Median = 2 & 0, respectively) (P < 0.01). Conclusion In patients who suffer from varicocele-related infertility or pain, microsurgical technique in sub inguinal varicocelectomy gives better results in improvement of semen quality and pain resolution when compared to the conventional technique.