Laparoscopic varicocelectomy: invasiveness and effectiveness compared with conventional open retroperitoneal high ligation.

The invasiveness of laparoscopic varicocelectomy and open retroperitoneal high ligation of the internal spermatic veins were compared and the surgical effects on fertility of these two procedures determined. 48 of 97 men diagnosed with varicocele testis underwent laparoscopic varicocelectomy, while the remaining 49 underwent open retroperitoneal high ligation of the internal spermatic vessels. Operating time, number of post-operative days to walking, length of hospital stay and analgesic use were measured as peri-operative indicators of invasiveness. In addition, seminal parameters were determined in order to evaluate the effects of these procedures on fertility. The operating time required for laparoscopic surgery was significantly longer than that for open surgery (96.6 vs 78.1 min., p = 0.0078). The patients in the laparoscopic surgery group began walking earlier post-operatively than did those who underwent open high ligation (0.97 vs 1.42 days, p = 0.00037). Length of hospital stay for the laparoscopic patients was shorter than for the open surgery group (7.05 vs 9.55 days, p = 0.00001). There were no statistical differences between the groups in terms of semen quality or improvement in the post-operative rate of pregnancy of partners. These findings indicate that laparoscopic varicocelectomy is associated with a shorter period of convalescence than open high ligation of the internal spermatic vessels.