A study of the surgical outcome and impact on semen parameters after laparoscopic varicocelectomy and sub inguinal varicocelectomy

Abstract

Introduction: Varicocele is the most widely encountered and surgically reversible cause of infertility to the male component, this entity can be defined as tortuous and dilated veins of pamp iniform plexus where dilatation is the result of retrograde blood flow through the internal spermatic veins. In young adults clinical evidence of varicocele is seen in 9% to 23% as suggested in most recent studies. In infertile males, varicocele is the finding in 40% of cases. Materials and Methods: This is prospective interventional study conducted from January 2020 to December 2020 in patients attending the OPD in the Department of General Surgery, Murshidabad Medical College and Hospital, Berhampore, Murshidabad, West Bengal. All the patients attending the department of general surgery, Murshidabad Medical College and Hospital, Berhampore underwent history elicitation, clinical examination, semen analysis (as per WHO manual 2010). Patients with abnormal semen parameters and clinical varicocele were selected. Doppler study of the scrotum (presence of varicocele graded using Sarteschi scale) was done for these patients. The patients fulfilling the selection criteria were counselled for varicocelectomy and consent for the study obtained. The patients were randomized into Group A (laparoscopic varicocelectomy) and Group B (sub-inguinal varicocelectomy) by random allocation method. Results: 50 patients were included in the study after they fulfilled the inclusion and exclusion criteria. The demographic parameters of the patients in both the arms were similar. Most of the patients belonged to age group 31-35 years followed by 26-30 years. There was no significant difference in both the arms when the grading of varicocele was compared both by clinical and by doppler examinations. Conclusion: Varicocelectomy improves the semen parameters. No significant variation was observed when the different surgical approaches of varicocelectomy were compared.