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COMPARISON OF THREE DIFFERENT PROCEDURES OF VARICOCELECTOMY IN PATIENTS OF INFERTILITY

Dr Naveed Sultan, Dr Muhammad Nadeem, Dr Abubaker

Abstract: 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 total two hundred and eight patients with infertility (four hundred and forty-six varicoceles) who got for varicocelectomy by an open inguinal procedure in ninety-two patients, laparoscopy in ninety-four patients & sub-inguinal microsurgeries in one hundred and twelve patients. We compared the all three procedures about intra-operative, initial & delayed parameters after surgery, 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 four to thirty-five months. Results: The surgery duration was much greater in the microscopic group of study. We compared the initial complications after surgery in all three groups. During the follow up period, no patient in the micro-surgical group found with hydrocele, whereas we observed that four out of 143 (2.80%) in the group of open procedure & eight out of 148 (5.40%) in the group of laparoscopy group, 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 (four out of 155 or 2.60% patients’ vs sixteen out of 143 or 11.0% & twenty-five out of 148 or 17.0%, 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. KEY WORDS: Infertile, Micro-Surgery, Laparoscopy, Varicocelectomy, Varicocele, Motility, Prevalence.

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