Comparison Between Microsurgical Varicocelectomy With And Without Testicular Delivery For The Treatment Of Varicocele

Objective:To investigate whether it is necessary to delivery testicle during microsurgical subinguinal varicocelectomy(MSV). Methods:We conducted a prospective 、 randomized 、 controlled study to evaluate the treatment outcome of MSV with and without testicular delivery for the treatment of varicocele.From Apr.2014 to Feb.2015,100 patients with varicocele were recruited by strict inclusion criteria.All of them were divided into two groups randomly.Patients in observation group(n=50) underwent testicular delivery during MSV and the others in control group(n=50) underwent MSV without testicular delivery. ALL patients were followed-up at 3、6、12months after surgery.The operative time,postoperative hospitalization time,semen parameter, complication rate,recurrence rate,natural pregnancy rate of both groups were compared and analyzed. Result:The surgical time of observation group was significantly longer than control group(P<0.001).There was no significant difference in the postoperative hospitalization time between the two groups(P>0.05).The semen parameter of both groups at the 12 month follow-up had significant improvement compared to the data before operation(P<0.001),but there was no significant different at 3、6、12 months between the two groups.The incidence of complication was higher in observation group(P<0.05).Follow up of 12 month after operation showed that natural pregnancy rate and recurrence rate were not significantly different between the two group(P>0.05). Conclusion:MSV with testicular delivery can not provide extra benefit to reduce the risk of recurrence and improve the quality of semen compared with MSV with testicular delivery.What is more,there was a higher risk of complication and a longer surgery time with testicular delivery during MSV.We concluded that MSV without testicular delivery can be a better program for the treatment of varicocele.