Comparative Study of Surgical Outcome of Different Approaches in 90 Patients of Varicocele at Gmc Baramulla, Jammu and Kashmir

Abstract

Background: Varicocele is the most commonly diagnosed prepubertal andrological condition and is an abnormal dilatation, lengthening and tortuosity of the veins of the spermatic cord. The clinical presentation of varicocele may vary from dull and dragging unilateral or bilateral testicular pain to visible varicose veins lying over the hemiscrotum.

Methods: A total number of 90 male adolescents with varicoceles were treated at the department of General Surgery at Govt. Medical College Baramulla Kashmir from January 2018 to December 2023 by three recognized surgical techniques viz., scrotal, trans inguinal and high ligation (Palomo's technique) and the results of surgical outcome in the three mentioned surgical approaches were compared.

Conclusion: We concluded that trans inguinal method is the best one for the correction of varicocele with easy approach, fewer complications and shorter hospital stay. There was a marked improvement in sperm quality and testicular volume in patients operated by this route.

Results: 56.6% of patients belonged to age group 15-20 years and in 90% of cases, left sided testis was involved. Among 6 patients who were infertile 2 (33.3%) patients became fertile and 4 (66.6%) patients had no effect on their fertility potential after varicocele correction. A significant change in testicular volume was noticed post operatively in all the 3 methods. A statistically significant improvement in sperm count (>50 million per ml) was observed in Trans inguinal technique while a significant improvement in sperm motility (>60%) was seen in trans inguinal and Palomo's approach.