Open palomo technique versus laparoscopic varicocelectomy

ABSTRACT

Aim: is to compare varicocelectomy by conventional open high ligation [palomo] and the laparscopic technique. Patients and Between June 2000 and December 2002; forty patients suffering from varicocele in Surgery Department, Menoufiya University Hospital; 20 of those patients treated by palomo operation [GPI]. The other 20 patients treated by laparoscopic varicocelectomy [GPII]; pre-operative semen analysis; Doppler examination, Dupler u/s., Blood picture, liver function, urine and stool analysis. Post-operative seminogram was also performed; follow up period 6 +/- 3 and 3 +/- 2.5 months for GPI and II, respectively. 40 patients suffering of 69 varicocels of various grades -Group I 12 cases [32.4%] grade III, 15 cases [40.5%] grade II and 10 cases [27%] grade I. -Group II 10 cases [31.2%] grade III, 20 cases [62.5%] grade II and 12 patient [6.25%] grade I. Primary infertility was detected in 8 patients [40%] of group I and in 5 patients [25%] of group II; secondary infertility was detected in 3 patient [15%] of group I, and in 3 patient [15%] out of group II. In these cases pre-operative seminogram showed oligoasthenoteratospermia. Post-operative seminogram showed significant increase in the number and motility after treatment in both groups in addition to reduction of abnormal forms. Again, the large varicocele showed greater post-operative semen quality improvement. Shorter mean operative time and less cost in group I and higher recurrence rate in group II [P<0.05]. The open palomo technnnique is a safe, simple minimally invasive, short time and less cost consuming but laparoscopic varicocelectomy is suitable for bilateral cases