Background: Varicocele is the abnormal tortuosity and dilatation of the testicular vein within the spermatic cord. The incidence of varicocele is approximately 16% in the normal adult population. Laparoscopic varicocelectomy is a minimally invasive procedure that is easy to perform with simple instruments. It is the best approach when recurrent disease and obesity are problems. The clear visualization and magnification provide facilitate control of the affected vessels and enable detection of abnormal collateral channels, one of the major reasons for postoperative recurrence. Compared to the open technique, laparoscopic varicocelectomy has minimal postoperative morbidity, shorter convalescence and a faster return to normal activities. The subinguinal varicocele repair performed with local anesthesia is a safe, low morbid technique offering a quicker recovery period than laparoscopic approaches. Although laparoscopic repairs may offer a shorter recovery period when compared with standard inguinal varicocelectomies, this is not the case when compared with subinguinal approaches.
Aim: The aim of this study is to compare between the open and laparoscopic varicocelectomy approaches in treatment of Varicocele as regards postoperative results and efficacy of the technique.
Patients and methods: This study includes a total of 40 patients with a history of infertility, abnormal semen analysis, or clinically diagnosed varicocele. Our prospective study was conducted in General Surgery Department of Benha University Hospital between 2017 and 2019. 20 patients underwent sub-inguinal open varicocelectomy and 20 patients underwent laparoscopic varicocelectomy.
Results: 22 patients had unilateral varicocele while 18 had bilateral varicocele. 13 patients presented with pain, 15 patients presented with subfertility and 12 presented with swelling. 21 patients with grade II varicocele and 19 with grade III. Regarding the complications, 15 patients had no complications, 2 patients with wound infection, 5 patients developed epididimytitis, 3 patients had hydrocele and 7 with recurrence.
Conclusion: The laparoscopic varicocelectomy is better than open technique as regard operation time, post-operative complications (Wound erythema, wound infection, epididymitis, hydrocele and recurrence) and post-operative hospital stay while other studies revealed that the microsurgical technique is the best of all.