Clinical Comparison Between Microsurgical Subinguinal Varicocelectomy With And Without Testicular Delivery And Ligation Of Gubernacular Veins For The Treatment Of Varicocele

Objective: To investigate whether it is necessary to delivery testicle and ligation ofgubernacular veinsduringmicrosurgical subinguinal varicocelectomy(MSV).Methods: Adopt prospective study method,286 patients with infertility caused by varicocele in the Department of Urinary Surgery of Shengjing Hospital Affiliated to China Medical University from September 2017 to September 2019 were selected,and135 patients with left varicocele were randomly divided into 2 groups: control group(n=71)was given MSV with testicular deliveryandligation of gubernacular veins,and the observation group(n=64)was given MSV without testicular deliveryand ligation ofgubernacular veins.The operation time,hospitalization time,incision pain score,the length of incisions,the quality of sperm before and after operation,postoperative complications and recurrence rate of the two groups were observed and compared.Results: The operation time,hospitalization time,incision pain score and the length of incisions of observation group were significantly lower than those of control group,all with statistically significant differences(P < 0.05).The sperm concentration,sperm motility and sperm activate rate of the two groups after operation were significantly improved(all P < 0.05).There were no statistically significant differences in the above semen parameters between the two groups of patients with grade Ⅲvaricoceleafter surgery(all P>0.05).There were 8 scrotal edema cases and 1 hydrocele case in control group after MSV,but no any postoperative complications in observation group.The postoperative complication rate of observation group was 0%,which was lower than that of control group of 12.68%(P<0.05).None of the two groups of patients had recurrence after operation.Conclusion : MSV with testicular deliveryand ligation ofgubernacular veinscan not provide extra benefit over that without in improving semen parameters and reduce the risk of recurrence,what is more,it involved longer operation time and hospitalization time,longer incisions,more pain and a higher risk of postoperative complications.