Short-term outcome of unaided versus microsurgical inguinal varicocelectomy among infertile men with varicocele

Abstract

Objective: The objective was to determine the short-term outcome of unaided and microsurgical varicocelectomy on semen parameters and conception after 6 months in patients with infertility and varicocele. Patients and Methods: This was a randomized, prospective, interventional study that was conducted on men with infertility and varicocele. Patients were randomized into two groups. Patients in Group A underwent open inguinal varicocelectomy, whereas patients in Group B had the same surgery with microsurgical technique using ×3.5 magnification loupes. All the patients had preoperative seminal fluid analysis (SFA) performed on two occasions, a scrotal Doppler ultrasound and a postoperative SFA at 3 months and 6 months posttreatment. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software package version 23.0, and the level of significance was taken as 0.05. Results: Thirty patients participated in the study, 14 in Group A and 16 in Group B. The mean age in Groups A and B was 40.07 ± 7.7 and 39.44 ± 7.3 years, respectively. About 85.7% of patients in Group A had bilateral varicocele, whereas 14.3% had left-sided varicocele. In Group B, 75% had bilateral, whereas 25% were on the left side. There was a statistically significant improvement in sperm count, motility, and morphology in both the unaided and the microsurgical groups; however, there was no significant difference in the improvement of seminal parameters between the two groups except the morphology. The pregnancy rate was 14.3% in Group A and 25% in Group B. Overall pregnancy rate in this study is 20% after 6 months. Conclusion: Varicocelectomy leads to significant improvement in sperm parameters; however, there is no significant difference in outcome between unaided and microsurgical varicocelectomy.