1Department of Urology, First Affiliated Hospital of Soochow
University, Suzhou (215006), China; 2Andrology Center, Peking
University First Hospital, Peking University, Beijing (100034), China
Purpose: To investigate the efficacy and safety of retroperitoneal
laparoscopic varicocelectomy(RPLV) for patients with infertility,
a comparative study on RPLV and transperitoneal laparoscopic
varicocelectomy (TPLV) were performed.
Subjects and Methods: A total 76 male infertility patients
with unilateral left-sided varicocele and presented of vein reflux
were recruited and randomly into TPLV group and RPLV
grop. Clinical efficacy and safety were evaluated by physical
examination, spermatic vein diameter, and spermatic vein reflux
and semen analysis and pregnancy rate. The operative time and
complications include post operative scrotal pain; testis atrophy
and hydrocele were investigated.
Results: The operative time of RPLV group (36.22±7.74 min) was
significantly shorter than that of TPVL group (15.50±6.26 min)
(P<0.05) without serious intraoperative complications in both
groups. The semen quality were significantly improved in both
group with and pregnancy rate in TPVL and RPVL were 12 cases
(33.3%) and 14 cases (35.0%), while the clinical outcome showed
no significant different between two groups (P>0.05). Post operative
complications in TPVL group including scrotal pain 2(5.6%),
spermatic vein reflux recurrence 4 cases (11.1%), hydrocele 2 cases
(5.6%) and testis atrophy 1 case (2.8%), while in PTVL groups
showed spermatic vein reflux recurrence 3 cases (7.5%) only and the
total complications in TPVL group(25%) showed significantly lower
than that of in TPVL groups (7.5%) (P<0.05).
Conclusions: Our preliminary experience suggested that the
RPLV is safe and effective methods for treating vericocele with
minimal invasive and lower complications.