Technical modification of microsurgical varicocelectomy can reduce operating time.
OBJECTIVE
To evaluate the impact of a technical modification of the microsurgical subinguinal varicocelectomy on surgical operating time.


METHODS
We introduced a technical modification to the standard microsurgical subinguinal varicocelectomy (division of the spermatic cord package before microsurgical dissection) in January 1999, to simplify the procedure and reduce surgical operating time. We performed a retrospective review of surgical outcomes in 89 men who underwent microsurgical varicocelectomy before modification of the procedure and 76 men who underwent microsurgical varicocelectomy after modification of the procedure. We compared operating times (in minutes), intraoperative findings, improvement in semen parameters, and postoperative complications between the two groups.


RESULTS
Overall, 101 men underwent a left and 64 men bilateral microsurgical varicocelectomy. Operating time (mean +/- standard error of the mean) was significantly less for the modified procedure compared with standard microsurgical varicocelectomy (50.2 +/- 1.8 minutes versus 56.5 +/- 1.3 minutes for left-sided procedures and 81.7 +/- 2.6 minutes versus 104.0 +/- 4.0 minutes for bilateral procedures, respectively). No postoperative complications (including recurrence or clinical hydrocele) were identified at 6 weeks postoperatively. Total motile sperm count improved significantly in both groups after surgery.


CONCLUSIONS
The modified microsurgical varicocelectomy reduces surgical operating time significantly without compromising outcome.
Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. armand.zini@ssss.gouv.qc.ca
Armand
A
Zini
Anthony
A
Fischer
Debra
D
Bellack
Mark
M
Noss
Khaled
K
Kamal
Victor
V
Chow
Victor
V
Mak
D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D013997:Time Factors; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods