Clinical and therapeutic aspects of laparoscopic varicocelectomy: a cross-sectional study in Douala, Cameroon

Abstract

INTRODUCTION: Varicocele is an abnormal tortuosity of the pampiniform venous plexus and internal spermatic veins that drains the testicle. It is a well-recognized cause of decrease in testicular function, affecting approximately 15-20% of all males and 40% of infertile men globally. Principles of varicocele management consist of interrupting internal spermatic venous reflux while preserving the internal spermatic artery and the vas deferens. Treatment can be obtained through spermatic venous embolization or surgical, which could be performed by open or laparoscopic approach. The purpose of this study was to evaluate the clinical and therapeutic aspects of laparoscopic varicocelectomy in the city of Douala. METHODS: we report a descriptive cross-sectional study including a retrospective and prospective component. We reviewed files of patients who underwent laparoscopic varicocelectomy from January 2015 to May 2021. Clinical and diagnostic components of varicocele, indications and therapeutic outcomes were analyzed. RESULTS: we total of 71 patients were included in our study. The average age of patients was 34.34 years. Scrotal pain was the most represented clinical sign (46.48%). Varicocele was found on the left in 77.46% of patients. Scrotal pain represented 49.3% of the operative indications, and 81.70% of the patients had their spermatic arteries preserved. Vascular injury was the most common intraoperative complication with 5.63%, while peri-incisional pain (7.04%) was the most common post-operative complication. CONCLUSION: laparoscopic varicocelectomy is safe and beneficial with favorable outcome. However, there is limited availability of this approach in our setting, mainly due to lack of technical facilities and practitioners able to popularize it.