title: A prospective randomized comparative trial between open subinguinal and loupe assisted subinguinal varicocelectome: A single center experience.
abstract: BACKGROUND
  In our study, we reviewed efficacy and complication rates of open subinguinal varicocelectomy (OSV) and loupe assisted subinguinal varicocelectomy (LASV) using seminal and hormonal parameters in a prospective randomized study.
  
  
  METHODS
  We prospectively studied 60 males with Grade 2 and Grade 3 varicocele. Thirty patients underwent OSV and the other 30 patients underwent LASV. Intra-operative and post-operative complications along with pre-operative and post-operative seminal, hormonal parameters and testicular volume were compared between the groups.
  
  
  RESULTS
  Sperm count, motility and morphology increased significantly in both groups, but the improvement was significantly better in LASV group. (Group A - improvement in sperm count, motility and morphology by 25%, 8.5%, 10.3%, respectively and in Group B - improvement in sperm count, motility and morphology by 110%, 68.59%, 71.1%, respectively. Decrease in serum follicular stimulating hormone (FSH), luteinizing hormone (LH) and increase in serum testosterone were significant in both groups, but the improvement was significantly better in LASV group. (Group A - serum FSH and LH decreased by 17.2%, 23%, respectively and serum testosterone increased by 13.7% and in Group B - serum FSH and LH decreased by 56.9%, 56.65%, respectively and serum testosterone increased by 95.9%). The recurrence (OSV = 13.2% and LASV = 0,P= 0.01) and complication rates were significantly lower in LASV group.
  
  
  CONCLUSIONS
  Our study shows that LASV is significantly better than OSV regarding efficacy and complication rates.
authors.affiliation: Department of Surgery, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Hari Gopal
authors.initials: HG
authors.lastname: Vyas
authors.affiliation: Department of Surgery, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Vimal
authors.initials: V
authors.lastname: Bhandari
authors.affiliation: Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Anup
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Biswajit
authors.initials: B
authors.lastname: Nanda
authors.affiliation: Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Harbinder
authors.initials: H
authors.lastname: Singh
authors.affiliation: Department of Surgery, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
authors.forename: Subroto
authors.initials: S
authors.lastname: Bhowmick
keywords: Loupe assisted subinguinal varicocelectomy; open subinguinal varicocelectomy; varicocele