title: Microscopic Retroperitoneal Varicocelectomy With Artery and Lymphatic Sparing: An Alternative Treatment for Varicocele in Infertile Men.
abstract: OBJECTIVE
  To compare the therapeutic effect of arterial and lymphatic sparing microscopic retroperitoneal varicocelectomy (MRV) with that of microscopic subinguinal varicocelectomy (MSV) for treatment of varicocele in infertile men.
  
  
  METHODS
  We conducted a prospective and controlled study to evaluate the therapeutic efficacy of MRV and MSV for treatment of varicocele in infertile men. A total of 80 patients were randomly chosen to undergo MRV (n = 40) or MSV (n = 40) treatment. All patients were followed up at 3, 6, and 12 months after surgery. Semen parameters, pregnancy, recurrence, and complications were examined.
  
  
  RESULTS
  Mean operation time in the MRV group was significantly shorter than that in MSV group (38.92 ± 5.67 min vs 91.35 ± 15.08 min), and the number of observed spermatic veins in MRV group was significantly less than that in MSV group (3.59 ± 0.76 vs 18.22 ± 2.83). Sperm count and motility were significantly improved at 12 months follow-up in both groups compared with preoperative values, and the sperm count in the MRV group at 3 months was significantly higher than that in MSV group. Moreover, the incidence of scrotal edema was higher in the MSV group, although natural pregnancy rate was not significantly different between 2 groups at 1-year follow-up (42.1% vs 44.7%).
  
  
  CONCLUSIONS
  MRV with artery and lymphatic sparing is a simple and effective technique for treatment of varicocele in infertile men.
authors.affiliation: Department of Colon and Rectum, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Haishan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Xinquan
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Muchun
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huo
authors.affiliation: Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, Jilin, China. Electronic address: muandkamu_2012@aliyun.com.
authors.forename: Hai
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000601:surgery*; D007264:Inguinal Canal; D008297:Male; D008866:Microsurgery / Q000379:methods*; D061646:Operative Time; D011446:Prospective Studies; D012187:Retroperitoneal Space; D013085:Spermatic Cord / Q000098:blood supply; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications / Q000601:surgery*