Laparoscopic and open varicocelectomies advantages and disadvantages with subsequent Fertility recovery results

Background and Objectives: With laparoscopic varicocelectomy (LVV) invention, controversial ideas are developed regarding choosing the preferable method for surgical management of varicocele; accordingly, various comparative studies are required to evaluate safer and more productive technique. This study is aimed in observation of validity of both laparoscopic and inguinal open methods and their efficiency in producing fruitful male fertility progression. Cases and methods: This study is performed in a period of one-year (2017-2018), during which (60) cases of infertility due to varicocele pathophysiological consequences collected by simple random method. Of these (32) cases were laparoscopically managed (Group 1) and the other (28) cases managed by open inguinal method (Group 2). In these patients the basal spermatic analysis performed the parameters were below normal values. The presences of varicoceles were proved clinically and by ultrasound Doppler studies. The varicocelectomy operations for non-fertile purposes were excluded from study. The follow up carried on two monthly intervals for next (6) months by clinical examinations, US and BSA. Statistically SPSS version package 24 is used; presented data are used. Results: The included ages were (24 to 43) years. In (51) cases only left side and in (9) cases were bilateral (VV). Postoperative follow up showed an acute rising of motility and quality of sperms after 4-8 weeks period among laparoscopic group and reached minimum normal level at the end of 24 weeks and 9 (28.13%) cases achieved conception in the first year. In the opened group the changes were slow and remained for 24 weeks to achieve wanted normal parameters and 11 (39.3%) cases achieved conception. Laparoscopic group operative duration was (425) minutes for unilateral and (608) minutes for bilateral, while in open group operation duration was (35 5) minutes for unilateral and (505) minutes in bilateral. Regarding postoperative complications in laparoscopic group were; less painful, less disabling, least trauma, scars and complications. Conclusions: The laparoscopic varicocelectomy is promising method of treating varicocele for abnormal sperm parameters, uni or bilateral same ports approachability for especially in subclinical varicoceles. LVV was safer than open method from various points of but longer operation duration. However open group conceptive outcomes observed more beneficial than LVV. Key words; varicocelectomy- inguinal - Laparoscopic. Fertility.