[Comparison of four surgical procedures for the treatment of varicocele]

To compare the clinical effects of inguinal varicocelectomy, Palomo varicocelectomy,laparoscopic varicocelectomy, and microscopic varicocelectomy in the treatment of varicocele.

We retrospectively analyzed the pre- and post-operative clinical data about 318 cases of varicocele,108 treated by inguinal varicocelectomy,84 by Palomo varicocelectomy,68 by laparoscopic varicocelectomy, and 58 by microscopic varicocelectomy. We compared the operation time, hospital stay, pre- and post-operative sperm concentration and progressive motility, incidence of complications, rate of recurrence, and rate of sperm quality improvement among the four groups.

The operation times for the inguinal, Palomo, laparoscopic, and microscopic varicocelectomy procedures were(50. 3 ± 13. 9),(70. 4 ± 14. 3),(35. 1 ± 11. 1),and(65. 3 ± 13. 2) min, respectively, significantly shorter for the laparoscopic strategy than for the other three( P < 0. 05). The lengths of hospital stay of the four groups of patients were(6. 3 ± 1. 6),(5. 7 ± 1. 5),(4. 3 ± 1. 4),and(3. 4 ± 1. 3) d, respectively, remarkably shorter in the microscopic group than in the other three( P < 0. 05). The microscopic group also showed a significantly lower rate of postoperative complications, incidence of spermatic vein reflux, and recurrence( P < 0. 05) and higher rates of improvement in postoperative sperm concentration and progressive motility than the other three groups( P < 0. 05).

Microscopic varicocelectomy is superior to inguinal,Palomo and laparoscopic varicocelectomy procedures in the treatment of varicocele for its lower incidence of complications, higher rate of sperm quality improvement,and shorter length of hospital stay. It is therefore more suitable to be applied in community hospitals.