Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .
Laparoscopic versus Open High Ligation of the Testicular Veins for the Treatment of Varicocele
The purpose of this study is to determine the relative advantages of laparoscopic varicocelectomy compared to the conventional open high ligation of Palomo . We studied 193 patients who presented with varicocele . While 65 patients were treated by open high ligation of the testicular veins  , 128 patients had laparoscopic varicocelectomy .  In addition to varicocele ligation , 14 patients ( 11 % ) had laparoscopy-assisted right orchidopexy , and 5 patients ( 4 % ) had laparoscopic repair of concomitant right inguinal hernia . The mean hospital stay was 3.5 days and 1.3 days , respectively , and the recurrence rates were 10.8 % and 3.9 % , respectively . Return to normal activity was significantly earlier in Group II ( mean 4.5 days ) compared to Group I ( mean 8.9 days ) . There was no incidence of testicular atrophy in any case in the study , regardless of whether the testicular artery was ligated or preserved during surgery . We conclude that laparoscopic varicocelectomy is safe , effective and minimally invasive . In addition to its better cosmetic results and advantage in case of bilateral disease , it allows excellent exposure and control of the affected vessels . Furthermore , the shorter hospital stay and the earlier return to normal activities are very important advantages in recommending this technique as an efficient alternative to the open surgical method
Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .