Comparison of Extraperitoneoscopic and Transperitoneoscopic Techniques for the Treatment of Bilateral Varicocele

Abstract

Background and Purpose

: Laparoscopic varicocelectomy has been performed in patients with bilateral varicocele. This procedure could be performed either transperitoneally or extraperitoneally. The purpose of this study was to compare the effectiveness and morbidity of the two approaches.

Patients and Methods

: Twenty-one patients underwent transperitoneal repair. Twelve of them had complaints of infertility, and nine of them had pain. Eighteen patient underwent extraperitoneal repair. Twelve of them had complaints of infertility, and six of them had pain. All the patients with pain had clinical varicoceles. In each group, three patients with infertility had unilateral subclinical varicoceles.

Results

: No significant difference was found in the duration of surgery, artery-vein discrimination, or morbidity between the extraperitoneal and transperitoneal techniques. In both approaches, the previously infertile patients who have been followed more than 6 months had significant improvement in sperm counts and motilities (P < 0.05). There were no significant differences in the improvement in the extraperitoneal and transperitoneal groups.

Conclusion

: There was no significant difference between the transperitoneal and extraperitoneal techniques in terms of effectiveness and morbidity. The difficulty in identifying the internal spermatic vein and the additional cost of the balloon dissector for the extraperitoneal technique makes us prefer transperitoneal repair.