Comparison of different methods of treating varicocele

Varicocele treatment was performed in 331 patients. One hundred fifteen patients were operated upon according to the technique of Bernardi (1947), 80 patients underwent occlusion of the testicular vein by detachable balloons, 47 patients were treated with percutaneous sclerotherapy, and 89 patients underwent laparoscopic varicocele treatment. The laparoscopic occlusion of the testicular vessels was done in two different ways: (1) coagulation of the testicular veins with electrocoagulating tweezers, and (2) occlusion of the suprainguinal testicular vessel with metal clips and transection of the vessels. Laparoscopic Group 1 showed a clearly higher complication rate and recurrence rate in comparison with the other methods, whereas in Group 2 we observed the best results with only 4% complications and recurrences. Because of its higher complication rate and recurrence rate, laparoscopic electrocoagulation of the testicular veins proved to be inadequate.