Subinguinal microsurgical varicocelectomy: evaluation of the results

Introduction: Varicoceles have been established to be the commonest correctable cause of male infertility. Among the various methods available, microsurgical varicocelectomy has one of the lowest complication rates with low failure.

Patients and methods: Over a 4-year period, 100 patients underwent microsurgical varicocelectomy at our center. One hundred and forty-four surgeries were performed on 90 of these patients through a subinguinal approach and these form the study group. Only clinically diagnosed varicoceles were operated. Pre-operative semen values were compared with the post-operative values and statistical analysis performed using a non-parametric test. All 90 patients provided at least 1 post-operative semen report 3 months after surgery while 50 are on complete follow-up.

Results: Sperm count improved in 71% patients, normal motility in 60% and normal morphology in 49%. Seventeen of the 50 patients on full follow-up (34%) achieved pregnancy, with 16 of these being spontaneous. All patients achieving pregnancy showed improvement in sperm count, 13 improved in motility and 12 in morphology. All improvements were statistically significant. There were 21 (14.6%) minor complications with no testicular atrophy and 1 recurrence.

Conclusion: Microsurgical varicocelectomy is a safe and effective option for the management of varicocele-induced male infertility. It leads to improvement in all semen parameters and increases the possibility of spontaneous pregnancies.