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COMPARISON OF THREE DIFFERENT PROCEDURES OF VARICOCELECTOMY IN PATIENTS OF INFERTILITY

Dr Naveed Sultan, Dr Muhammad Nadeem, Dr Abubaker

Objective: The aim of this research work is to compare the consequences of three different procedures on the varicocelectomy in patients suffering from infertility with the utilization of the varicoceles. Methodology: There were 250 patients with infertility who got for varicocelectomy by an open inguinal procedure in 70 patients, laparoscopy in 75 patients & sub-inguinal microsurgeries in 105 patients. We compared the all three procedures about intra-operative, initial & delayed post operation parameters, alterations in the parameters of semen & rate of pregnancy. Average follow up duration of the patients was 21.0±9.0 months with a range from 30 to 35 months. Results: The surgery duration was much greater in the microscopic group of study. We compared the initial post-operative complications in all three groups. During the follow up period, no patient in the micro-surgical group found with hydrocele, whereas we observed that 3 /130 (2.50%) in the group of open procedure & 7 /138 (4.30%) in the group of laparoscopy, demonstrating an important disparity in the support of the microsurgery. The occurrence of the recurring varicoceles was much less in the micro-surgical group as compared to the other groups of open & laparoscopy (5 / 145 or 3.50% patients’ vs 18 / 153 (12.0%) & 28 / 158 (19.0%) correspondingly). In comparison with the values before surgery in all groups the parameters of semen after surgery displayed advancement in the concentration of sperm, sperm’s motility & morphology. The prevalence of the infertile patients with improved count of the sperm & their motility was very high in the group of micro-surgery. The rate of pregnancy was not much different in all the participants of each group. Conclusions: The comparison of all 3 techniques showed that micro-surgical varicocelectomy has high benefits as compared to the other methods as no formation of the hydrocele, very low occurrence of recurring varicocele and good improvement in the count & motility of the sperms. Keywords: Infertile, Micro-Surgery, Laparoscopy, Varicocelectomy, Varicocele, Motility, Prevalence.

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