Comparing Varicocele Repair Methods

Varicocele surgery is meant to stop the backward blood flow that makes varicocele develop. This is done by killing off the veins that circulate the blood. Typically a single, non-varicose vein is left open in attempt to allow for continued blood flow.

Surgical treatment methods include: Subinguinal (incision made in upper scrotum), inguinal (incision made in groin area), retroperitoneal (incision made in lower abdomen), laparoscopy (surgery using a camera, incision made in groin or abdominal area), radiologic (also called embolization, where valves are sealed off using metal coils, then killed using chemical, incision made in groin). In all cases, an incision is made and the varicose veins are cut out.

Bare in mind, it is true that couples who are infertile and have a sperm count less that 5 million/ml, and established infertility for at least one year are capable of achieving natural conception at a 36% rate without any therapy [1]. Therefore it is likely that neither varicoceletomy nor radiologic procedure results in any improvement in pregnancy, despite leading to some semen improvement [2].

Outcome Parameter	Incisional	Laparoscopic	Radiologic
Semen Improvement	66%	50-70%	60%
Pregnancy Rate	35%	10-35%	10-50%
Recurrence	5-15%	10-30%	10%
Technical Failure	5-15%	5-15%	10-20%