Modified microsurgical subinguinal varicocelectomy without testicular delivery

The aim of this study is to report our experience of modified microsurgical subinguinal varicocelectomy without delivery of the testes. We retrospectively evaluated 138 men treated with microsurgical varicocelectomy who took part in 1-year follow-up between 1997 and 2007. The varicoceles were grade III in 115 (81.6%), grade II in 23 (16.3%), and grade I in 3 (2.1%) men. We used a technical modification of the standard microsurgical subinguinal technique: division of the spermatic cord before microsurgical dissection, and the testes were not delivered. Patient age, varicocele grade, operation time, 1-year follow-up results, including complications, symptom relief, and recurrence, were recorded. We performed 141 varicocelectomies (Left: n = 135; bilateral: n = 3) in 138 men. The patients' mean age was 23.5 ± 2.7 (range: 11-45) years. The mean operation time was 69.6 ± 15.6 (range: 35-140) min. There were three complications (2.2%; post-operative haematomas: n = 2; wound infection: n = 1) and 6 recurrences (4.3%; grade II: n = 1; grade III: n = 5). Among the 86 patients with scrotal pain, 74 (77.9%) reported complete resolution of pain and 13 (12.9%) reported partial resolution. Modified microsurgical subinguinal varicocelectomy without testis delivery is safe and effective.