Comparison of the therapeutic effects of different operative options in the treatment of spermatic varicocele / 中华泌尿外科杂志

ABSTRACT

Objective To compare the therapeutic effects of 3 operative options with selective high level ligation of spermatic veins, transinguinal canal and renovated Potomo's laparoscopic manage-ment of varicocele. Methods From January 1990 to November 2006, 1075 primary varicocele above grade Ⅱ patients accepted the operations, of them, 685 patients had follow up data and were recruited into this study. These patients were divided into 3 groups according to the operative methods:group A (n=369) was treated with open selective high level ligation of spermatic veins, group B (n=218) was treated with open transinguinal canal operation, and group C (n=98) was treated by renovated Polo-mo's laparoscopic management of varicocele. The complications of the 3 operative methods were com-pared, such as recurrence rate, testicular atrophy rate, scrotal edema rate and semen analysis. The therapeutic effects of these 3 methods were evaluated. Results The recurrence rates of the 3 groups were 3.3%, 7.3% and 5.1%, respectively. Group A had significantly lower recurrence rate than group B, P<0.05. The testicular atrophy rates of 3 groups were 0.5%, 17.9% and 9.2%, respec-tively. There were significant differences among the 3 groups (P<0.05). The scrotal edema rates of the 3 groups were 1.4%, 17.4% and 16.3%, respectively. Group B and C had higher risk of scrotal edema than group A, P<0.05. For patients with ages younger than 30, the improved semen quality rate in group A was higher than in group B and C. The improved semen quality rate in each group of patients younger than 30 was higher than patients with age over 30. Conclusion The open selective high level ligation of spermatic veins is the best choice in the treatment for patients with primary sper-matic varicocele.