title: Comparison of Treatment Outcomes of Different Spermatic Vein Ligation Procedures in Varicocele Treatment.
abstract: In this study, 4 different spermatic vein ligation procedures for varicocele (VC) treatment were compared based on recurrence rate, postoperative complications, and semen quality. Between January 2012 and May 2013, a total of 345 male patients with VC were recruited at The First Affiliated Hospital of Soochow University. Patients were performed by different ligation procedures, and they were divided into 4 groups: laparoscopic varicocelectomy group (LV group: n = 84), microscopic inguinal varicocelectomy group (MIV group: n = 85), microscopic retroperitoneal varicocelectomy group (MRV group: n = 86), and microscopic subinguinal varicocelectomy group (MSV group: n = 90). In MSV group, the operative time was 55 ± 6.9 minutes, which was significantly longer than LV, MIV, and MRV groups (P < 0.05). Recurrence rate in LV group was at 11.9%, the highest rate observed compared with the MIV, MRV, and MSV groups (P < 0.05). Scrotal edema and testicular atrophy in MSV group were markedly decreased (P < 0.05), and scrotal pain was relieved in almost all patients in the MSV group at a significantly higher rate than LV, MIV, and MRV groups (P < 0.05). Sperm concentration, sperm count of grades a + b, and sperm motility (%) in the MSV group were sharply higher than LV, MIV, and MRV groups (all P < 0.05). Our study indicates that MSV is the most beneficial of the 4 spermatic vein ligation procedures and may be offered as the first-line treatment for VC in infertile men.
authors.affiliation: 1Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou, China; 2Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China; and 3Operation Room, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Jin-Xing
authors.initials: JX
authors.lastname: Lv
authors.forename: Liang-Liang
authors.initials: LL
authors.lastname: Wang
authors.forename: Xue-Dong
authors.initials: XD
authors.lastname: Wei
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Tian-Lan
authors.initials: TL
authors.lastname: Zheng
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Huang
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Fei
authors.initials: F
authors.lastname: Xia
authors.forename: Jin-Xian
authors.initials: JX
authors.lastname: Pu
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation; D008297:Male; D008866:Microsurgery / Q000379:methods*; D061646:Operative Time; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D012611:Scrotum / Q000473:pathology*; D055101:Semen Analysis; D013076:Sperm Count; D013737:Testis / Q000473:pathology; D016896:Treatment Outcome; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult