Evaluating the Efficacy of Microscopic Varicocelectomy in the Treatment of Primary and Recurrent Varicocele

Objectıve: Varicocele is the most common and correctable cause of male infertility. Microscopic subinguinal varicocelectomy is the golden standard in the treatment of this disease, and recurrence is the most common complication. The aim of this study was to investigate the outcomes of microscopic varicocelectomy in primary and recurrent varicocele. Materıals and Method: The data of 20 patients undergoing left subinguinal microscopic varicocelectomy due to left varicocele for the first time and 20 patients undergoing the same operation for the second time due to recurrence between April 2015 and May 2017, were retrospectively evaluated. Semen analyses, testicular volumes and complication rates were compared between the groups both prior to and 12 months after the operation. Fındıngs: The mean age was 30.2±1.4 in the primary varicocele group and 31.3±1.1 in the recurrent varicocele group (p>0.05). No significant difference was observed between the pre- and the post-operative values of testicular volume in patients undergoing primary microscopic varicocelectomy (3.2±1.4 ml and 3.1±1.7 ml, respectively; p>0.05); however, a significant improvement was observed in sperm count, motility and morphology parameters (10.3±2.9 millions/ml, 28.2±7.8%, 2.2±1.4% and 11.3±3.3 millions/ml, 30.2±6.8%, 2.5±1.8%, p<0.05). In the recurrent varicocele group, no significant difference was observed between the pre- and post-operative semen volume (3.23±1.7 ml and 2.4±1.6 ml, p>0.05), whereas a significant improvement was observed in sperm concentration, morphology and motility parameters (9.6±3.3 millions/ml, 20.3±4.5%, 2.3±1.7% and 11.6±2.6 millions/ml, 23.2±7.5%, 2.5±1.9%, p<0.05). The testicular volume was observed to have increased in the post-operative period in both primary and recurrent varicocele groups (12.5±2.6 ml and 13.2±3.4 ml vs. (11.8±2.4 ml and 12.3±2.7 ml), which was not statistically significant (p>0.05). Conclusion: Microscopic subinguinal varicocelectomy, which is related to the highest success rates and lowest recurrence and complication rates in the treatment of varicocele, may be safely used in the treatment of recurrent varicocele as well.