Comparative Study between Open and Laparoscopic Varicocelectomy in Bilateral Varicocele | ||||
| International Journal of Medical Arts | ||||
| Article 15, Volume 6, Issue 5, May 2024, Page 4452-4459 PDF (1.76 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2023.180812.1571 | ||||
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| Authors | ||||
Ahmed Hamoda Ahmed Awad-Allah  1; Mohamed Mustafa Balbola1; Mohamed Mohamed Shahin2; Magdi Elghannam3; Mostafa M Shakweer 4
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| 1Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt | ||||
| 2Department of Pediatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt | ||||
| 3Department of Clinical Pathology , Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt | ||||
| 4Department of Radiodiagnosis, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt | ||||
| Abstract | ||||
| Background: Varicoceles are tortuous, abnormally dilated scrotal veins. Although there are variations in recurrence rates, none of the surgical techniques outlined for varicocelectomy have been shown to be superior to the others in their ability to increase fertility. Aim of the work: Comparison between open and laparoscopic varicocelectomy in bilateral varicocele regarding outcome and complications. Patients and Methods: One-hundred patients with bilateral primary varicocele and sperm count below 20 million/c.c., were randomly allocated into either open surgical varicocelectomy via sub inguinal approach, or laparoscopic varicocelectomy. For each patient, operative time, recovery rate and complications were reported. Semen analysis, serum sex hormones [Testosterone, FSH and LH] levels were analyzed preoperatively, 3 and 6 months after surgery. Results: In the laparoscopic group, there was statistically significant lower operative time than the open group [22±8.6 vs. 28±6.2; P=0.03]. Also, the laparoscopic group had significant lower hospital stay [P=0.01] and rapid return to normal activity [P=0.01] than the open group. Regarding complications, four patients in the laparoscopic group developed pneumo-scrotum versus none in the open group [P=0.01]; otherwise, the overall complication rate was higher in the open group [P=0.04]. Sperm count and motility were improved in both groups after 3 and 6 months; however, abnormal forms of sperms were improved only in the laparoscopic group [P=0.05]. Conclusion: Laparoscopic varicocelectomy was associated with shorter operative time, hospital stay, and rapid return to normal activity. Furthermore, overall complication rate was less with laparoscopic varicocelectomy except for pneumo-scrotum, which was more frequent with laparoscopic varicocelectomy. | ||||
| Keywords | ||||
| Varicocele; Varicocelectomy; Laparoscope; Semen analysis | ||||
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