title: [Treatment of idiopathic varicocele: comparative study of three techniques about 128 cases].
abstract: BACKGROUND
  Several modalities of varicocele treatment are available, however, no therapeutic technique showed its superiority with regard to the other one.
  
  
  OBJECTIVE
  To compare the results of three techniques of varicocelecomy.
  
  
  METHODS
  Retrospective Analytical and comparative study of 128 patients treated by of three techniques of varicocelectomy: the open surgery by retro peritoneal way for 42 patients (GI), the varicocelectomie coelioscopique for 41 patients (GII) and the antegrade scrotal sclerotherapy done for 45 patients (GIII), between march 2001 and January 2009.The mean age was 28 years. The main motive for consultation was represented by the painful varicocele in 67 % of the cases, followed by the hypofertility in 20.3 % of the cases and the association both in 12,5 % of the cases. The varicocele was in leftsider in 71.1 % of the cases, to the right side in 5.4 % of the cases and was bilateral in 23.43 % of the cases. Varicocele was infra-clinical at 6 patients, grade 1 in 16 sides, grade 2 in 105 sides and grade 3 in 31 sides. The numeration, the mobility as well as the morphology of sperm cells were comparable between the three groups Results: The global rate success was 81.2 %, with the highest rate found in the group III which was treated by antégrade scrotal sclerotherapy (84.4 %). The improvement of the parameters of the spermogramme was noted in the three groups, however a statistically significant difference was found only in patients treated by antégrade scrotal sclerotherapy; it mainly concerned numeration and the mobility of spermatozoides. The highest rate of pregnancy was recorded in patients treated by antégrade scrotal sclerotherapy (13.3%). The main postoperative complications were hydrocele (16%) followed by testicular hypotrophy (3 patients).
  
  
  CONCLUSIONS
  Three techniques of varicocele treatment, offer either a similar success rate, and improvement of parameters of the sperm cells. However, antegrade scrotal sclerotherpy seem to be the best treatment of first intention in proposed, regarding its efficiency, of the ease of its realization, its moderate cost and its feasibility in case of recurrence if varicocele was treated with open way'GIII).
authors.affiliation: Hopital des FSI La Marsa, Tunisie.
authors.forename: Hassen
authors.initials: H
authors.lastname: Khouni
authors.forename: Nizar
authors.initials: N
authors.lastname: Bouchiba
authors.forename: Melik Melek
authors.initials: MM
authors.lastname: Khelifa
authors.forename: Moez
authors.initials: M
authors.lastname: Ben Ali
authors.forename: Akrem
authors.initials: A
authors.lastname: Sebai
authors.forename: Meriem
authors.initials: M
authors.lastname: Dali
authors.forename: Mehdi
authors.initials: M
authors.lastname: Charfi
authors.forename: Adnene
authors.initials: A
authors.lastname: Chouchene
authors.forename: Faycel
authors.initials: F
authors.lastname: El Kateb
authors.forename: Habib
authors.initials: H
authors.lastname: Bouhaouala
authors.forename: Med Hedi
authors.initials: MH
authors.lastname: Balti
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000379:methods; D055101:Semen Analysis; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D014646:Varicocele / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D055815:Young Adult