الفهرس 
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Abstract
Forty patients with bilateral symptomatic varicoceles indicated
for surgical repair were included in the study. They were divided
into two groups (٢٠ patients each) in a random pattern. The first
group of patients underwent laparoscopic varicocelectomy and the
other group underwent open high inguinal varicocelectomy
(Modified Palomo). Detailed urological and medical history including general and
local examination routine preoperative investigations (CBC, random
blood sugar, liver function profile, BUN and serum creatinine,
prothrombin time and concentration) Semen analysis, Scrotal
ultrasound and Colour duplex on the pampiniform plexus of veins. Intraoperative and early post-operative evaluation was done
for type of anesthesia, time of the operation, testicular artery
preservation, complications, analgesia, post-operative hospital stay
and return to activity Follow up ٣ months postoperative was done for improvement
of semen parameters and incidence of hydroceles and recurrence . Results The mean age was ٢٤±٤.٢ and ٢٣.٢±٣.٢ years for laparoscopic
and open group respectively, the difference between the two groups
was statistically insignificant. Pain was the presenting symptom in ١٨ and ١٧ patients while
infertility was presented in ٢ and ٤ patients respectively in
laparoscopic and open group. The mean operative time was ٧٦.١±١٩.٨ minutes and ٤٧.٨±٧.٦
minutes for both laparoscopic group and open group respectively. It
was significantly shorter among patients in the open group. Testicular artery could not be identified and was inadvertently
divided in ١١ varicoceles (٢٧.٥%) and in ٧ varicoceles (١٧.٥%) in
open group and laparoscopic group respectively. Both open and laparoscopic surgery were performed as a one day
procedure and patients returned to work and daily regular activity after
٦.٩ ± ٠.٩(days) and ٣.٦ ± ١.١ (days) in open and laparoscopic procedures
respectively, with a difference of statistical significance (P<٠.٠٥). The cost of open surgery was low in comparison to the cost of
laparoscopy. The post operative follow up showed statistically significant
results concerning semen parameters, shown in increased of the
density of sperms with a mean of ٥٨.٢٥ & ٥٦.٩ million/ml, increased
motility with a mean of ٦٥.٨ & ٦٣.٣٥ %and reduction of the
percentage of the abnormal forms with a mean of ٢٧.٦٥ & ٢٧.٥ % for
laparoscopic and open groups respectively. The recurrence rate was ٢ varicoceles (٥%) in laparoscopic group
and ٤ varicoceles (١٠%) in open group. Hydroceles were reported ٤ hydroceles (١٠%) in laparoscopic
group and ٨ hydroceles (٢٠%) in open group.