Avoidance of hydrocele after non microsurgical varicocelectomy by pre-emptive eversion of tunica vaginalis in infertile men with varicocele

Abstract

Background: In infertile men with varicocele, controlled studies clearly indicate that varicocelectomy improves pregnancy rates. Non microsurgical varicocelectomy is associated with many complications; hydrocele is the most common one. Many techniques have been done to reduce the incidence of post-varicocelectomy hydrocele which is somewhat difficult to be done. This study aimed to evaluate the efficacy of pre-emptive eversion of tunica vaginalis in avoidance of post-operative hydrocele after non microsurgical varicocelectomy and its effect on fertility.Methods: A total number of 115 infertile men with varicocele underwent varicocelectomy during August 2015 to December 2016 in Sohag university hospital. Fifty five patients underwent bilateral microsurgical varicocelectomy (group A), were compared with 60 patients who underwent bilateral non microsurgical varicocelectomy with pre-emptive eversion of tunica vaginalis (group B) as regard, development of post-operative hydrocele, operative time, complication rates, hospital stay and effect on spontaneous pregnancy.Results: Group A has longer duration of surgery (26±11.7minutes versus 20±10.2minutes) while there was no significant difference in hospital stay (6±2.5 hours versus 6±1.5 hours) in both groups. No post-operative wound infection in both groups. There was one case (1.6%) develop scrotal haematoma in (group B) only. No post-operative recurrence in both groups. No post-operative hydrocele developed in both groups. Improvement in sperm count, motility and morphology occurred in both groups. No significant difference in percentage of paternity during 6-24 months.Conclusions: Pre-emptive eversion of tunica during non- microsurgical varicocelectomy might be offered as an adjunctive technique to avoid development of post-operative hydrocele that is easy, not time consuming and has comparable results of microsurgical varicocelectomy.