[Microsurgical subinguinal varicocelectomy with delivery of the testis and ligation of gubernacular veins: Evaluation of clinical effects].

Objective: To compare the clinical effects and postoperative complications of microsurgical subinguinal varicocelectomy (MSV) with or without delivery of the testis and ligation of gubernacular veins in the treatment of varicocele.

METHODS: We retrospectively analyzed the clinical data about 163 varicocele patients treated by MSV, 40 with (group A) and the other 123 without delivery of the testis and ligation of gubernacular veins (group B). We compared the operation time, postoperative complications, rate of recurrence, and semen parameters before and at 3 months after surgery between the two groups of patients.

RESULTS: The operation time was significantly longer in group A than in B (［81.1 ± 20.0］ vs ［62.3 ± 9.6］ min, P = 0.041). Sperm concentration, total sperm count per ejaculate, sperm viability, and the percentage of progressively motile sperm were significantly improved in both groups at 3 months after MSV as compared with the baseline (P < 0.05). There were no statistically significant differences in the above semen parameters between the two groups of patients with grade Ⅲ varicocele before and after surgery (P < 0.05). Scrotal edema developed in 5 cases in group A and wound infection in 2 cases in group B after MSV, but no postoperative testicular atrophy or recurrence was observed in either of the two groups.

CONCLUSIONS: MSV with delivery of the testis and ligation of gubernacular veins showed no advantages over that without in reducing varicocele recurrence and improving semen parameters, but rather involved longer operation time and a higher incidence rate of postoperative complications.