Comparison of Outcome in Open and Laparoscopic Varicocelectomy

Abstract

Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Several methods have been used for its treatment including open surgical ligation of the spermatic vein as well as laparoscopic and microsurgical varicocelectomy. Open varicocelectomy has more risk of complications. Laparoscopic varicocelectomy is simple, easily mastered and has less risk of complications. Moreover, laparoscopic approach is better than open approach in treating bilateral varicocele. Laparoscopic varicocelectomy may be suggested to be used more often in future if the results of this study show relative benefits. Objective: To compare laparoscopic varicocelectomy with open varicocelectomy in patients with varicocele in terms of mean operative time and frequency of wound infection. Study Design: Randomized clinical trial. Setting: Punjab Medical College and affiliated hospitals Period: Study was carried out for one year from 27-9-2013 to   26-09-2014 Methodology: A total of 164 patients of varicocele were included in the study. All patients were diagnosed clinically as having varicocele.82 patients underwent laparoscopic varicocelectomy (group A) and 82 open varicocelectomy (group B). Outcome in terms of operative time and wound infection was compared in both groups. Results: Mean age in group A was 30.55 years with a standard deviation of 8.87. Mean age of patients in group B was 30.56 years with a standard deviation of 8.08. Wound infection in group A was11% and 34.1% in group B.  P value was 0. 0001. Operative time in group A was 27.44+/-3.31(min) and 36.79+/-3.49(min) in group B.  P-value was 0.0001. Conclusion: Outcome of laparoscopic varicocelectomy is better than open varicocelectomy in patients of varicocele.