title: Laparoscopic versus inguinal (Ivanissevich) varicocelectomy.
abstract: OBJECTIVE
  To compare the postsurgical outcome of laparoscopic and open inguinal varicocelectomy.
  
  
  METHODS
  Quasi-experimental study.
  
  
  METHODS
  Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, from July 2003 to June 2007.
  
  
  METHODS
  One hundred seven patients underwent either open inguinal or laparoscopic varicocelectomy. Diagnosis was made by clinical examination and color Doppler scan in doubtful cases. Pre-operative semen analysis was done in all patients. Operative time, postoperative analgesic requirement in number of tablets, hospital stay in days, improvement in semen parameters in subfertile subjects, pain on visual analog score. and postoperative complications were recorded and compared between the two groups.
  
  
  RESULTS
  There were 50 patients in each group, with age ranging from 12-50 years (26.9+/-7.67 in open inguinal and 26.2+/-7.08 in laparoscopic group). Average operative time was 34.8+/-7.89 minutes for open inguinal and 43.8+/-8.95 minutes for laparoscopic group. The analgesic requirement was 16.3+/-1.58 tablets in the open inguinal and 11.3+/-2.23 in the laparoscopic group. Postoperative pain was significantly less in the laparoscopic group. There was statistically significant (p < 0.001) improvement in sperm count as well as motility in both groups irrespective of procedure.
  
  
  CONCLUSIONS
  The open inguinal (Ivanissevich) procedure and laparoscopic varicocelectomy had almost equivalent postoperative outcomes regarding improvement in semen parameters and postoperative complications. Open inguinal procedure had a shorter operating time while laparoscopic varicocelectomy had the advantage of less analgesic requirement and short hospital stay. On the whole, open inguinal (loupe magnified) varicocelectomy is an effective procedure where availability and costs of laparoscopic instruments are barriers.
authors.affiliation: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. ahmedsangrasi@hotmail.com
authors.forename: Ahmed Khan
authors.initials: AK
authors.lastname: Sangrasi
authors.forename: Abdul Aziz
authors.initials: AA
authors.lastname: Leghari
authors.forename: Aisha
authors.initials: A
authors.lastname: Memon
authors.forename: K Altaf
authors.initials: KA
authors.lastname: Talpur
authors.forename: Aamir Iqbal
authors.initials: AI
authors.lastname: Memon
authors.forename: Jan Mohammad
authors.initials: JM
authors.lastname: Memon
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D011184:Postoperative Period; D012008:Recurrence; D012086:Reoperation; D012661:Semen; D013085:Spermatic Cord / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult
chemical_list: D000700:Analgesics