CU 57. Efficacy and safety of retroperitoneal laparoscopic varicocelectomy: A comparative study with transperitoneal laparoscopic varicocelectomy

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.