Total Bilateral Extraperitoneal Varicocelectomy with Hernioplasty

Abstract

Background: A varicocele is characterized by the abnormal dilation of veins draining the testis. In many cases, a varicocele coexists with an inguinal hernia, either presenting with symptoms or remaining asymptomatic. This study aimed to evaluate the efficacy of laparoscopic total extraperitoneal varicocelectomy with concomitant hernioplasty. Method: A 27-year-old male presented to the surgical outpatient department with a painless inguinoscrotal swelling. Physical examination revealed a reducible 3 × 3 cm swelling with a positive cough impulse. Bilateral examination revealed a grade 3 varicocele and a reduced right inguinal hernia. The patient underwent laparoscopic surgery, with caution taken to avoid the use of energy sources. Results: Pre op sperm count was 16 million/ml and after 1 month improved to 34 million/ml. Sperm motility improved grossly, pre op majority of sperms were dead and it improved to 58.3%. Conclusion: Laparoscopic varicocelectomy by extra peritoneal route is a safe procedure and avoids intraperitoneal adhesions and bowel injury as compared to transabdominal pre peritoneal route.