Varicocelectomy: An Efficient and Inexpensive Treatment for Male Factor Infertility

Background: A case of varicocele, with primary infertility and a deranged semen parameter presenting at the surgery outpatient clinic, He had open varicocelectomy with a significant improvement in semen parameters. Objective: To identify the significance of varicocelectomy in improving semen parameters, in patients with varicocele. To identify the role of open varicocelectomy in managing a case of varicocele in areas where other modalities of management such as embolization, laparoscopy cannot be performed or is unaffordable for patients. Case presentation: A 41years old man presenting at the surgery outpatient clinic with left scrotal swelling. It was noticed 10 years prior to presentation. Scrotal swelling was noticed to have gradually increased in size. There was a history of associated pain and discomfort. He also had a history of inability to achieve conception with several girlfriends. There was a positive history of penile discharge, no dysuria. There was a history of generalized rash which started from the perineum, but resolved on treatment, and reoccurs occasionally. He had a semen analysis done which had a deranged result. He occasionally consumes alcohol and smokes locally prepared. With no significant improvement in achieving conception, he presented to our facility. Scrotal examination revealed a swollen left hemiscrotum with mild tenderness & a “bag of worm feel” of the spermatic cord. Seminal fluid analysis was deranged. An assessment of a grade 3, varicocele was made. Patients had open varicocelectomy done with subsequent improvement of semen parameters. Conclusion: Varicocelectomy is a useful method of improving semen parameters in patients with male infertility caused by varicocele. Open varicocelectomy is accessible and affordable in the management of varicocele in areas where other methods such as embolization, laparoscopy cannot be performed or is unaffordable.