Microsurgical Subinguinal or Laparoscopic Palomo Varicocelectomy in adolescent patients, which technique is better?

The indications for surgical intervention in adolescent varicocele cases are restricted. When intervention is necessary, treatment options include the open subinguinal approach, laparoscopic surgery, or embolization. This study aimed to compare outcomes between microsurgical sub-inguinal varicocelectomy and laparoscopic varicocelectomy in adolescent patients. Forty-nine patients under 18 years old who underwent varicocelectomy between 2010 and 2023 were categorized into two groups based on the surgical approach 19 patients underwent laparoscopic varicocelectomy by pediatric urologists, and 30 patients underwent SV by the urology department. Patient records were retrospectively analyzed for age, preoperative symptoms, physical examination findings, ultrasound results, surgical techniques, and postoperative outcomes. There was no significant difference in recurrence rates between subinguinal varicocelectomy and laparoscopic varicocelectomy techniques. However, statistically significant differences were noted in operative duration, hospital stay length, and patient age at the time of surgery between the pediatric urology and urology department groups employing different techniques. Both subinguinal varicocelectomy and laparoscopic varicocelectomy techniques can be considered based on the surgeon's expertise and institutional resources. Regardless of the approach chosen, preserving arterial and lymphatic structures to maintain testicular blood supply and minimize complications is paramount.