Vyas Hari Gopal, Bhandari Vimal, Kumar Anup, Nanda Biswajit, Singh Harbinder, Bhowmick Subroto
Department of Surgery, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
Urol Ann. 2017 Jan-Mar;9(1):13-17. doi: 10.4103/0974-7796.198899.
In our study, we reviewed efficacy and complication rates of open subinguinal varicocelectomy (OSV) and loupe assisted subinguinal varicocelectomy (LASV) using seminal and hormonal parameters in a prospective randomized study.
We prospectively studied 60 males with Grade 2 and Grade 3 varicocele. Thirty patients underwent OSV and the other 30 patients underwent LASV. Intra-operative and post-operative complications along with pre-operative and post-operative seminal, hormonal parameters and testicular volume were compared between the groups.
Sperm count, motility and morphology increased significantly in both groups, but the improvement was significantly better in LASV group. (Group A - improvement in sperm count, motility and morphology by 25%, 8.5%, 10.3%, respectively and in Group B - improvement in sperm count, motility and morphology by 110%, 68.59%, 71.1%, respectively. Decrease in serum follicular stimulating hormone (FSH), luteinizing hormone (LH) and increase in serum testosterone were significant in both groups, but the improvement was significantly better in LASV group. (Group A - serum FSH and LH decreased by 17.2%, 23%, respectively and serum testosterone increased by 13.7% and in Group B - serum FSH and LH decreased by 56.9%, 56.65%, respectively and serum testosterone increased by 95.9%). The recurrence (OSV = 13.2% and LASV = 0, = 0.01) and complication rates were significantly lower in LASV group.
Our study shows that LASV is significantly better than OSV regarding efficacy and complication rates.
在我们的研究中,我们通过前瞻性随机研究,利用精液和激素参数回顾了开放腹股沟下精索静脉曲张切除术(OSV)和放大镜辅助腹股沟下精索静脉曲张切除术(LASV)的疗效和并发症发生率。
我们前瞻性地研究了60例患有2级和3级精索静脉曲张的男性。30例患者接受了OSV,另外30例患者接受了LASV。比较了两组之间的术中及术后并发症,以及术前和术后的精液、激素参数和睾丸体积。
两组的精子计数、活力和形态均显著增加,但LASV组的改善明显更好。(A组 - 精子计数、活力和形态分别提高了25%、8.5%、10.3%,B组 - 精子计数、活力和形态分别提高了110%、68.59%、71.1%。两组血清促卵泡生成素(FSH)、黄体生成素(LH)均下降,血清睾酮均升高,但LASV组的改善明显更好。(A组 - 血清FSH和LH分别下降了17.2%、23%,血清睾酮升高了13.7%,B组 - 血清FSH和LH分别下降了56.9%、56.65%,血清睾酮升高了95.9%)。LASV组的复发率(OSV = 13.2%,LASV = 0,P = 0.01)和并发症发生率显著更低。
我们的研究表明,在疗效和并发症发生率方面,LASV明显优于OSV。