A comparison between the efficacy and safety of microscopic inguinal and subinguinal varicocelectomy

Özet

Objective: To compare microscopic inguinal (MIV) and subinguinal varicocelectomy (MSV) surgeries with respect to efficacy and safety.Material and methods: Patients who underwent varicocelectomy between January 2002 and January2018 were evaluated retrospectively and prospectively. The patients who underwent varicocelectomyuntil December 2015 were analyzed retrospectively and the cases after January 2016 were analyzedprospectively. In our study, the married infertile male cases were compared on the basis of operationduration, number of ligated veins, number of preserved veins, postoperative pain score (visual analogue scale: VAS), patient satisfaction, surgeon satisfaction, changes in sperm parameters, testicularconsistency, pregnancy rates, and complications, such as hydrocele, testicular atrophy, and recurrenceof varicocele. Surgical success rates were compared by semen analysis between unmarried infertilemale cases because pregnancy rates cannot be tested. The patients were recalled for control examinations every 3 months for 1 year and tested the above-mentioned parameters. Statistical Package for theSocial Sciences Version 20 Windows Software was used for data analysis and comparison between thetwo groups.Results: The study included a total of 136 adult patients. Mean age of the patients was 28.14 (20–41)years. MSV and MIV were performed in 62 (45.6%) and 74 (54.4%) patients, respectively. No statistically significant difference was detected between the two groups in terms of admission duration, semenparameters within the 1-year follow-up process, hormonal changes, and complication rates. Operationduration was significantly longer in the MSV group. It was determined that a fewer number of veinswere ligated, and a fewer number of veins needed to be ligated in the MIV group. The analysis of allthe patients revealed that pain scores at 4 and 24 hours postoperatively were significantly statisticallylower in the MSV group.Conclusion: MIV and MSV are distinct, efficient, and safe surgical techniques with specific advantages and disadvantages. Their efficacy and safety rates are similar.