Sclerotherapy versus surgery in the treatment of varicocele: a randomized study

ABSTRACT

To evaluate the differences between surgical and seminological results observed in two groups of patients with primary varicocele who underwent, respectively, open surgery or antegrade sclerotherapy. From Jan. 2005 to Jan. 2006, we recruited 60 patients with left sided varicocele for this study. Before treatment all patients were evaluated by a physical examination, color Doppler ultrasonography of the spermatic cord, and abdominal and scrotal ultrasonography and semen analysis. These patients were randomized to two groups; group A 30 patients [open surgery] and B 30 patients [antegrade sclerotherapy]. At the current follow up, it is possible to evaluate all the patients for whom we have preoperative and postoperative Doppler imaging and semen analysis. A satisfactory significant improvement of the rate of fast progressive spermatozoa and reduction in immotile spermatozoa in those patients who underwent sclerotherapy compared to the patients who underwent open surgery. The outcomes of all other parameters [number and morphology] are fully comparable. Operating time is decidedly shorter for antegrade sclerotherapy, but there are no significant differences in terms of early or late postoperative complications. Our results demonstrate that sclerotherapy combines shorter surgical time and faster recovery of normal daily activities with significant improvement in sperm motility