Assessing safety and efficacy of microscopic and laparoscopic varicocoelectomy for varicocoele treatment: A comparative cohort study

Abstract

Surgical is appropriate for 35-40% of varicocoele-induced infertility. This comparative observational study presents a comparative assessment of microscopic or laparoscopic varicocoelectomy (grade II varicocoele; n=132 cases). Sperm count, density, total motility, and forward motility rate (preoperative and postoperative 6 months), operation duration, pain at 1 month, testicular atrophy (by scrotal ultrasound at 3 months), recurrence (angiography at 6 months), and scrotal edema (at 12 months) were measured. The preoperative semen parameters were comparable between groups (P>0.05), as were certain postoperative results (total sperm count [median 162 (range 100-242) compared with median 182 (range 84-253)]; sperm density [median 47 (range 38-83) compared with median 42 (range 27-88)]; forward motility (37.18±4.14 compared with 34.13±7.79); P>0.05). However, sperm motility was higher in the microscope group (52.79±8.21 compared with 46.64±10.04; t=2.304, P=0.040). Within the microscope group, postoperative sperm density [median 47 (range 38-83)], total sperm motility (53.79±8.25), and forward motility sperm rate (37.19±4.14) demonstrated significant improvements compared with preoperative values (Z=-2.679, P=0.005; t=-4.548, P<0.001; t=-5.029, P<0.001). In contrast, the postoperative forward motility sperm rate (34.13±7.78) displayed substantial improvements compared with preoperative values (27.74±14.42) within the laparoscopic group (t=-3.895, P=0.001). Testicular atrophy occurred in neither group. Microscopic varicocoelectomy may be safer and more effective.