Laparoscopic en mass versus elective internal spermatic vein ligation technique for varicocele
Ching-Che Lin1, Kuan-Wei Shi, Ting-En Tai, An-Chi Chou, Yao-chou Tsai1,2
1Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan
2Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Purpose: The aim of this study was to compare outcome measures between laparoendoscopic en mass ligation and selective spermatic vein ligation technique for varicocele
Materials and Methods: Between March 2010 and October 2019, a total of 51 patients underwent laparoscopic varicocelectomy were retrospective reviewed. Of these, 31 patients underwent en mass ligation(group 1) technique and 20 patients underwent selective spermatic vein ligation technique(group 2). Peri-operative outcome, post-operative testes volume, peri-operative semen analysis were compared beteween the two groups.
Results: There was no significant difference in baseline characteristics such as age, body mass index, varicocele grading. No significant differences were found between group 1 and group 2 with the respect to the operative time(51.16±22.82, 59.52±16.12minutes, respectively, p=0.057), left testis size(19.01±5.49, 19.13±4.92, respectively, P=0.86),right testis size(19.18±5.19, 19.34±4.66 mL, respectively, P=0.88), Hormone profile(such as FSH level, testosterone level), VAS score. Significant difference was found with the respect of semen concentration(post-operative 3 months)(427.69±435.55, 1076.67±443.20 *10^5/cc respectively, P<0.05), but no significant difference was found between 2 groups afterwards at 6 months follow-up in semen concentration.
The findings of the present study suggest that en mass ligation is as safe as selective spermatic vein ligation technique for varicocele. We found that early recovery of semen concentration at 3-month follow-up. Furthermore, post-operative semen motility and concentration after 6 months of follow-up also showed no significance. Operative techniques were based on the surgeon’s preference in our study. Further randomized study is mandatory for our study.