Varicocele: Evaluation of Current Surgical Techniques

Abstract

Varicocele is an abnormal dilatation and tortuousity of the testicular veins due to reflux of blood in the internal spermatic vein . Varicocele is the most common surgically correctable cause of male infertility . Varicocele is found in approximately 15% of the general population and up to 39% of infertile men . approximately 80-98% occur on the left side . Varicocele has been known to be associated with a progressive duration dependant testicular damage . the impaired testicular function in patients with varicocele is expressed by deranged seminal findings ,histological testicular changes , and decreased testicular size . many of varicocele patients has an evidence of decreased testicular hormone production . The most common method of identifYing varicocele is physical examination , however, this method is somewhat subjective . therefore , other more objective diagnostic tests are used , namely; venography , Doppler velocimeter ,colored Duplex ultrasound ,thermography and radionuclide angiography. Most researchers agree that correction of varicocele improves sperm quality and fertility rates . Correction of varicocele can be done by various surgical methods or by radiological occlusive techniques . the goal of surgery is complete disruption of the internal spermatic veins ,and preservation of the vas with it' s blood supply and lymphatics. The aim of this work was to compare the short term results of inguinal varicocelectomy ,high ligation varicocelectomy and laparoscopic varicocelectomy as regards operative data and postoperative semen analysis and, Duplex study. The age of patients was between 21 and 38 year's old .the patients was evaluated by pre and postoperative physical examination semen analysis and Duplex ultrasound . 30 Patients was randomly selected for each technique with left side primary varicocele with or without right varicocele .