Microsurgical subinguinal varicocelectomy in patients with recurrent or persistent varicocele

Abstract

Introduction:Varicocele may be treated with many different modalities including radiological and surgical approaches but what is the best treatment remains controversial. The recurrence rate following varicocele repair is up to 45%. The aim of this study is to investigate the efficacy of microsurgical varicocelectomy in varicocele recurrence. Methods: In our clinic, 32 men who treated with persistent or recurrent varicocele were evaluated retrospectively. All patients were treated with artery and lymphatic sparing subinguinal microsurgical technique. Age, pre-operative and post-operative semen parameters, serum testosterone levels, post-operative pregnancy rates, testicular volumes, and complications were recorded and analyzed. Results: Postoperatively, mean serum testosterone levels increased. Median sperm concentrations and motility rates also increased. With a minimum 6-month follow-up, the overall pregnancy rate was 37.5% (n=12) including 18.7% (n=6) of pregnancies achieved through natural intercourse, 9.3% (n=3) of them with IVF/intracytoplasmic sperm injection, and 9.3% (n=3) with intrauterine insemination. No complications such as hydrocele, hematoma, and wound infection were observed during the follow-up period. Discussion and Conclusion: In this study, treatment of recurrent varicocele with subinguinal microsurgical technique seems to be effective method with improving semen parameters and without a significant risk of post-operative complications.