the Effect of Different Modialites of Varicocelectomy on Semen Parameters in Patient With Normal Semen Analysis

Study Overview
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Brief Summary
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to evalute the effect inguinal and subinguinal approach of varicoceclectomy on semen parameter for patients complaining of varicocele with normal semen parameter (pain is the main complaint)

Detailed Description
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the varicocele is defined as dilated and incompetent veins within the pampiniform plexus of spermatic cord. varicocele has been described as the most common surgically correctable cause of male subinfertility.this is a disease that devolops during puberty when both endocrine and exocrine function of the testicle dramatically increases, along with testicular blood flow. varicocele only rarely detected in boys less than 10 years. left sided varicocle found in 15% of healthy young men.incontrast, the incidence in sub fertile men approaches 40% bilateral varicocele is uncommon in healthy men (less than 10%) but palpated in 20% in sub fertile men. in-general varicocele don't spontaneously regress. an accurate physical examination remain the corner stone of varicocele diagnosis. several anatomic features contribute to the predominance of left sided varicocele is the left intrnal spermatic vein longer than the right and it typically joins the left renal vein at a right angle.as result of this character higher venous pressures fair transmited to the left spermatic vein and result in reterograde reflux of blood. varicocle are associated with testicular atrophhy and varicocle correction can reverse atrophy in adolececnt. there is strong evidence affect semen quality it can cause abnormalties in concentration, motility and morphology.main defect is the motility. indication of varicocelectomy: Large varicoceles in adolescents Childhood varicocele with testicular atrophy Varicoceles with elevated FSH values, or low testosterone levels Varicoceles with scrotal pain Cosmetic indication Male infertility with pathological semen analysis and varicocele

Official Title
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Comparison Between Impact of Inguinal and Subinguinal Approaches of Varicocelectomy on Semen Parameters in Patients With Normal Semen Analysis

Conditions
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Varicocele

Intervention / Treatment
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* Procedure: High inguinal Varicocelectomy
* Procedure: Subinguinal varicocelectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age more than 19 years old primary varicocele Exclusion Criteria: secondary varicocele recurrent varicocele age less than 19 years

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| high inguinal approch<br>Patients undergoing high inguinal varicocelectomy with normal pre operative semen parameters, post operative semen analysis parameters will be recorded | Procedure: High inguinal Varicocelectomy<br>* Semen parameters after high inguinal varicocelectomy will be collected<br>|
| subinguinal approch<br>Patients undergoing subinguinal varicocelectomy with normal pre operative semen parameters, post operative semen analysis parameters will be recorded | Procedure: Subinguinal varicocelectomy<br>* Semen parameters after subinguinal Varicocelectomy will be collected<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Semen analysis | Motility morphology concentration | 3months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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infertility, pain, pregnancy