Varicocelectomy by means of subinguinal cremasteric compartment disruption and venous ligation

To evaluate the efficacy of addition of disruption of the cremasteric compartment to venous ligation in infertile men with varicocele and abnormal semen parameters.

A prospective non-randomized study was undertaken in 380 infertile men with varicocele and abnormal semen parameters. They were operated on using subinguinal venous ligation with the addition of cremasteric compartment disruption on an outpatient basis.

Following surgery, the median values for each semen parameter were compared preoperatively and 1-year postoperatively using the Wilcoxon signed rank test. The difference in the median values was significant for all the parameters. Over a minimum 2-year follow-up period, 304 men (80%) contributed to pregnancies leading to live births.

The results suggest that subinguinal venous ligation with the addition of cremasteric compartment disruption is a physiological, economic and safe option for varicocele repair in men with abnormal sperm parameters. A high rate of unassisted pregnancy compared to conventional isolated venous obliteration is achievable, with minimal morbidity and recurrence.