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Updated: Jul 8, 2026

Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Laparoscopic management of varicocele using bipolar cautery versus open high ligation technique: a randomized,
Nasser Simforoosh1, Seyed Amir Mohsen Ziaee, Saeed Behjati
1Department of Urology, Urology Nephrology Research Center, Shaheed Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. simforoosh@iurtc.org.ir
Purpose:
The aim of this investigation was to compare laparoscopic management of varicocele using bipolar cautery with open high ligation technique.
Materials And Methods:
A total of 100 patients were operated on for left-sided varicoceles. To evaluate the clinical efficiency of the treatment, the patients were divided randomly into two groups. A laparoscopic varicocelectomy (LV) was performed on 50 patients, and an open varicocelectomy (OV) was performed on 50 patients. Outcome data examined operating time, relapse rate, presence of hydrocele, wound complications, postoperative length of stay, and pain control. In both groups, the operations were performed with the preservation of lymphatics and artery with ligation of the veins in the retroperitoneum above the internal inguinal ring.
Results:
The operative time was 17.2 +/- 9.8 minutes in LV versus 31.02 +/- 12.8 minutes; in OV (P = .00). In LV versus OV, relapse rates were 8% versus 4% (P > 0.05), hydrocele occurrence was 14% versus 24% (P > 0.05), and wound complication was 0.00% versus 6%. Hospital stay was an average of 12 hours in both groups. Postoperative analgesic use was 3.6 +/- 0.4 mg in LV versus 3.5 +/- 0.5 mg in OV (P > 0.05).
Conclusions:
The clinical efficacy of LV using bipolar cautery is superior to traditional OV.

