Assessing Safety and Efficacy of Microscopic and Laparoscopic Varicocoelectomy for Varicocoele Treatment: A Comparative Cohort Study.

Background: Surgical is appropriate for 35-40% of varicocoele-induced infertility. This comparative observational study presents a comparative assessment of microscopic or laparoscopic varicocoelectomy (grade II varicocoele; n = 132 cases).Methods: Sperm count, density, total motility, and forward motility rate (preoperative and postoperative 6 months), operation duration, pain at 1 month, testicular atrophy (by scrotal ultrasound at 3 months), recurrence (angiography at 6 months), and scrotal edema (at 12 months) were measured.Results: The preoperative semen parameters were comparable between groups (P > 0.05), as were certain postoperative results (total sperm count [median 162 (range 100-242) compared with median 182 (range 84-253)]; sperm density [median 47 (range 38-83) compared with median 42 (range 27-88)]; forward motility (37.18 +/- 4.14 compared with 34.13 +/- 7.79); P > 0.05). However, sperm motility was higher in the microscope group (52.79 +/- 8.21 compared with 46.64 +/- 10.04; t = 2.304, P = 0.040). Within the microscope group, postoperative sperm density [median 47 (range 38-83)], total sperm motility (53.79 +/- 8.25), and forward motility sperm rate (37.19 +/- 4.14) demonstrated significant improvements compared with preoperative values (Z = -2.679, P = 0.005; t = -4.548, P < 0.001; t = -5.029, P < 0.001). In contrast, the postoperative forward motility sperm rate (34.13 +/- 7.78) displayed substantial improvements compared with preoperative values (27.74 +/- 14.42) within the laparoscopic group (t = -3.895, P = 0.001). Testicular atrophy occurred in neither group.Conclusions: Microscopic varicocoelectomy may be safer and more effective.(c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.