Ga. Barbalias et al., TREATMENT OF VARICOCELE FOR MALE-INFERTILITY - A COMPARATIVE-STUDY EVALUATING CURRENTLY USED APPROACHES, European urology, 34(5), 1998, pp. 393-397
Objective: To evaluate the results of four currently used approaches f
or the treatment of clinically diagnosed varicoceles, and compare thei
r influence on semen parameters. Methods: We prospectively evaluated 8
8 patients, 23-39 years old (mean age 31), with a clinically diagnosed
varicocele. Patients were allocated randomly to be treated either by
a retroperitoneal (group A), inguinal (group B), subinguinal (group C)
, or percutaneous venous embolization approaches (group D). All patien
ts were evaluated 6 and 12 months postoperatively. Results: Clinical r
ecurrence of varicocele occurred in 4 patients of group A (18.2%), 1 p
atient of group B (4.5%), and 2 patients of group D (9.1%). Hydrocele
formation was seen in 1 patient of group B (4.5%), and 2 patients of g
roup C (9.1%). In all groups statistically significant improvement as
to the sperm concentration was found in both the 6- and 12-month follo
wup. This significance was more prominent in group C followed by group
s B and D, and finally by group A. As to sperm motility, in group C th
ere was a statistical significance in both follow-up evaluations, and
in group B statistical difference was reached only in the 12-month eva
luation. Sperm morphology did not differ in any of the groups postoper
atively compared to the preoperative values. Conclusions: The subingui
nal approach disclosed a more prominent improvement in both semen conc
entration and motility in the 6- and 12-month follow-up evaluation whe
n compared to the other techniques. Furthermore, due to its simplicity
and avoidance of opening the external oblique fascia, we believe it r
epresents the more plausible approach when treating clinical varicocel
e.