Effect of varicelectomy on testicular functions

ABSTRACT

Thirty patients with primary varicocele were subdivided into two groups Group I [15 patients] subjected to ligation of the internal spermatic vein in the inguinal canal through an inguinal approach and group II [15 patients] subjected to ligation of internal spermatic vein above the level of the internal inguinal ring through retroperitoneal approach. Patients were examined daily in early postoperative period to detect the immediate complications including wound infection, scrotal edema, scrotal hematoma, edema of the scrotal contents and orchalgia. Also, follow up of the cases was performed for three months for the incidence of delayed complications, such as testicular atrophy, hydrocele formation, inguinal hernia and recurrence of residual veins. It was found that there was an increase in incidence of immediate and delayed complications in the inguinal approach than in the retroperitoneal approach. There is an affection of the testicular function in almost all cases of primary varicocele as most patients showed improvement in the parameters of semen analysis postoperatively. The severity of this affection is not related to the degree of varicocele or its duration. Ligation of the internal spermatic vein alone is the rational treatment of varicocele. Ligation of the internal spermatic vein in the retroperitoneal space is to be preferred than its ligation in the inguinal canal as it is followed by less complications