Comparison Of The Therapeutic Effects Of Microscopic Versus Retroperitoneal High Ligation Varicocelectomy On Semen Quality For Primary Varicocele

Micro-surgery and retroperitoneal high ligation are two commonly used surgical approaches to varicoceletomy. In order to provide clinicians evidence for choosing a safe and effective surgical approach, we evaluated the incidence of the complications and the therapeutic effects of this two approaches. From July 2011 to May 2014, we collected 88 hospitalized varicocele patients in Baogang hospital, which were all single diseases and had no history of retroperitoneal area or pelvic area surgery. Sterile marriage is the main reason for treatment. Other reasons are perineal discomfort or found by physical examination without any symptoms. All the patients are aged from 19 to 37 years (mean age 24.2 years). Patients were randomly divided into two groups, group A:retroperitoneal high ligation,46 cases; group B:micro-surgery,42 cases. Compare the time of operation, postoperative hospital stay, complications, semen quality, recurrence, therapy effects and testicular volume of the two groups. As a results, the time of operation in the micro-surgery group was significantly longer than that in the retroperitoneal high ligation group (P<0.05), but the time of hospital stay of the micro-surgery group was shorter than that of retroperitoneal high ligation group (P<0.05).The incidence of recurrence was 0.00% in the micro-surgery group, which was significantly lower than that in the retroperitoneal high ligation group [8.6%(4/46)] By comparing the symptoms improvement rate of pain in scrotum and the incidence rate of hydrocele or scrotal edemas 1week,2,4, or 6 months after the surgery, we found that the symptoms, such as scrotal pain and bulge, were better improved. Furthermore, the complications, such as scrotal edema and hydrocele, were rarer in the micro-surgery group than that in the retroperitoneal high ligation group (P<0.05). Sperm motility and sperm deformity rate were significantly improved in both groups (P<0.05), and semen quality in the micro-surgery group was better improved than that in the retroperitoneal high ligation group (P<0.05). However, there is no significantly difference in the testicular volume between the two groups (P>0.05).As a conclusion, the time of operation in the micro-surgery group was significantly longer than in the retroperitoneal high ligation group. However, micro-surgery is better than retroperitoneal high ligation in improving the recurrence, semen quality and incidence of complications. Therefore, micro-surgery is a satisfactory approach to varicoceletomy.