Abstract:

Objective To investigate the improvement in procedures of varicocelectomy for varicocele (VC), and observe the incidences of complications after modified operation. Methods Seventy-eight patients with VC undergoing varicocelectomy were studied. Among them, 28 were treated with modified procedures of varicocelectomy, in which the spermatic vein and its main branches were separately ligated and the ilioinguinal nerve, iliohypogastric nerve and lymphatics were protected (modified varicocelectomy group). The other 50 patients were managed with traditional varicocelectomy (traditional varicocelectomy group). The incidences of complications and semen parameters (sperm concentration, percentage of mobile sperm and percentage of progressively mobile sperm) after operation were analysed. Results Spermatic vein was successfully ligated in all the 78 patients. The complications after operation in traditional varicocelectomy group were hydrocele (n=14, 28.0%), epididymitis (n=10, 20.0%) and numbness of left inner thigh within 1 month after operation (n=1, 0.5%). The complications after operation in modified varicocelectomy group were hydrocele (n=1, 3.6%) and epididymitis (n=1, 3.6%), and there was no other short-term complications. The prevalences of hydrocele and epididymitis after operation in modified varicocelectomy group were significantly lower than those in traditional varicocelectomy group (P＜0.05). The semen parameters in both modified varicocelectomy group and traditional varicocelectomy group 3 to 6 months after operation were significantly improved (P<0.05 or P<0.01). No significant difference was demonstrated in the improvement of semen parameters between two groups (P>0.05). Conclusion Both the modified procedures of varicocelectomy and traditonal varicocelectomy for VC can improve the sperm quality, while the former can effectively reduce the incidence of complications after operation.

Key words: varicocelectomy, complication, ilioinguinal nerve, iliohypogastric nerve, lymphatic