Introduction. Varicocele is one of the leading causes of male infertility. Despite the availability of various surgical techniques, the optimal approach remains controversial due to differences in recurrence rates, complications, and recovery time.
Objective. To compare the effectiveness of laparoscopic varicocelectomy, microsurgical subinguinal varicocelectomy, and an original minimally invasive surgical technique for varicocele treatment.
Materials and methods. A prospective randomized single-center study included 120 patients with grade I–III left-sided varicocele, divided into three equal groups. Surgical time, length of hospital stay (LOS), postoperative pain (VAS), complication and recurrence rates, and spermogram parameters were assessed. Follow-up lasted up to 24 months.
Results. The original technique was characterized by a significantly shortest operative time – 14±2 min vs to 45±4 min for microsurgery and 50±5 min for laparoscopic ligation (p<0.001). The LOS was 1,1±0,3 days, also statistically significantly shorter than in other groups. The 24-month recurrence rate for the original technique and microsurgery was comparable (2,5% each) and significantly lower than after laparoscopic ligation (10,0%; p<0.05). Pain intensity after 2 weeks was minimal in the original technique group – 3.4±0.8 points on VAS (p<0.01). At the 6-month follow-up, improvement in semen parameters (concentration, motility, morphology) in the microsurgery and original technique groups was significantly more pronounced than after laparoscopic ligation (p<0.001).
Conclusion. The original minimally invasive technique is an effective and safe alternative to microsurgical varicocelectomy, providing comparable clinical and functional outcomes with reduced operative time and hospitalization.
