Microsurgical and conventional correction of varicocele. Comparison of its results in infertile patients.
Keywords:
varicocele, microsurgery, semen.Abstract
Introduction: Varicocele is the surgically correctable cause that most often causes infertility in men. Multiple techniques have been used for its correction, from conventional open surgery to microsurgery.
Objective: Describe the main results obtained with microsurgical varicocelectomy and compare these with different conventional techniques.
Method: Quasi-experimental study, with historical controls in different centers of the province of Pinar del Río, between 2008 - 2020. The results of amplified varicolectomy with surgical glasses were compared with those obtained with Palomo and conventional subinguinal techniques.
Results: Hydrocele was the most frequent of all complications, with a total of 26 patients. With microsurgery, it appeared in only two patients (4.1%) and with the conventional technique in 24 patients (15.7%). Epididymitis was not reported with the microsurgical technique and appeared in 13.7% of patients with the traditional approach. Wound-related complications occurred in 6.1% and 4.6% of those operated on, whom underwent microsurgical and conventional varicocelectomy respectively. The persistence of varicocele showed no differences between the two techniques. With microsurgical varicocelectomy, improvement of semen parameters was achieved in 81.60% of patients and pregnancy in 34.70% of couples.
Conclusions: Microsurgical varicocelectomy guarantees superior results to conventional techniques in terms of seminal parameters, the number of pregnancies and the reduction of postoperative complications.Downloads
References
2. Abou Ghayda R, El-Doueihi RZ, Lee JY, Bulbul M, Abou Heidar N, Bulbul J, et al. Anthropometric Variables as Predictors of Semen Parameters and Fertility Outcomesafter Varicocelectomy. J Clin Med. 2020 [acceso 13/07/2021];9(4):1160. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230912/
3. Elesawy FM, Abdel Hafeez NA, Abdelsalam OH, Akl EM. Soluble Fibrinogen-like protein 2 plays a role in varicocele induced male infertility. Andrologia. 2020 [acceso13/07/2021];52(6):e13626. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32350910/
4. Çayan S, Akbay E, Saylam B, Kadıoğlu A. Effect of Varicocele and Its Treatment on Testosterone in Hypogonadal Men with Varicocele: Review of the Literature. Balkan Med J. 2020 [acceso 13/07/2021];37(3):121-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161614/
5. Chou Rodríguez A, Fragas Valdés R, Hernández Silverio DR, Rodríguez Verde E, Palacios Jiménez P. Varicocele bilateral e infertilidad: evaluación de dos técnicas quirúrgicas. Rev Cubana Urol. 2013 [acceso 13/07/2021];2(1):53-69. Disponible en: http://www.revurologia.sld.cu/index.php/rcu/article/view/47/35
6. Turgut H. Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery, 2020 [acceso 13/07/2021];7(3):195-9. Disponible en: https://www.researchgate.net/publication/343782149_Early_Period_Evaluations_after_Varicocelectomy_Semen_Analysis_and_Spontaneous_Pregnancy_Rates
7. Vela Caravia I, Caravia Pubillones I, Milian Echevarría R. Actualización sobre aspectos anatómicos, fisiopatológicos y diagnósticos del varicocele. Rev Cubana Urol. 2019 [acceso 14/12/2021];8(2):149-63. Disponible en: http://www.revurologia.sld.cu/index.php/rcu/article/view/484/613
8. Almaramhy HH, Aly M. Magnified and non magnified subinguinal varicocelectomy in infertile and/or symptomatic men: A comparative study of the outcome. Afr J Urol. 2012 [acceso 13/07/2021];18(4):161-6. Disponible en: https://www.sciencedirect.com/science/article/pii/S1110570412001014
9. Al-Kandari AM, Khudair A, Arafa A, Zanaty F, Ezz A, El-Shazly M. Microscopic subinguinal varicocelectomy in 100 consecutive cases: Spermatic cord vascular anatomy, recurrence and hydrocele outcome analysis. Arab J Urol. 2018 [acceso 13/07/2021];16(1):181-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922226/
10. Hosseini K, Nejatifar M, Kabir A. Comparison of The Efficacy and Safety of Palomo, Ivanissevich and Laparoscopic Varicocelectomy in Iranian Infertile Men with Palpable Varicocele. Int J Fertil Steril. 2018 [acceso 13/07/2021];12(1):81-7. Disponible en: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5767938/
11. Ameli M, Ahmadzadeh M, Khajavi A, Nabizadeh M. Evaluation of the success rate and complications of conventional varicocelectomy: Do we need microscopic surgery really? Urologia. 2019 [acceso 13/07/2021];86(1):23-6. Disponible en: https://journals.sagepub.com/doi/full/10.1177/0391560318758938
12. Johnson D, Sandlow J. Treatment of varicoceles: techniques and outcomes. Fertil Steril. 2017 [acceso 13/07/2021];108(3):378-84. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28865535/
13. Fırat F, Erdemir F. The Effect of Age on Semen Quality and Spontaneous Pregnancy Rates in Patients who Treated with Microsurgical Inguinal Varicocelectomy. Cureus. 2020 [acceso 13/07/2021];12(4):e7744. Disponible en: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7241228/
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cual estará simultáneamente sujeto a la Licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
