A prospective randomized comparative trial between open subinguinal and loupe assisted subinguinal varicocelectome: A single center experience.

INTRODUCTION: In our study, we reviewed efficacy and complication rates of open subinguinal varicocelectomy (OSV) and loupe assisted subinguinal varicocelectomy (LASV) using seminal and hormonal parameters in a prospective randomized study.

MATERIALS AND METHODS: We prospectively studied 60 males with Grade 2 and Grade 3 varicocele. Thirty patients underwent OSV and the other 30 patients underwent LASV. Intra-operative and post-operative complications along with pre-operative and post-operative seminal, hormonal parameters and testicular volume were compared between the groups.

RESULTS: Sperm count, motility and morphology increased significantly in both groups, but the improvement was significantly better in LASV group. (Group A - improvement in sperm count, motility and morphology by 25%, 8.5%, 10.3%, respectively and in Group B - improvement in sperm count, motility and morphology by 110%, 68.59%, 71.1%, respectively. Decrease in serum follicular stimulating hormone (FSH), luteinizing hormone (LH) and increase in serum testosterone were significant in both groups, but the improvement was significantly better in LASV group. (Group A - serum FSH and LH decreased by 17.2%, 23%, respectively and serum testosterone increased by 13.7% and in Group B - serum FSH and LH decreased by 56.9%, 56.65%, respectively and serum testosterone increased by 95.9%). The recurrence (OSV = 13.2% and LASV = 0, P = 0.01) and complication rates were significantly lower in LASV group.

CONCLUSION: Our study shows that LASV is significantly better than OSV regarding efficacy and complication rates.