الفهرس 
Title : 0Comparative study between Microsurgical Subinguinal Varicocelectomy with the standard technique and the new pulling technique : A Prospective comparative study
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Abstract
To compare the efficacy of microsurgical subinguinal varicocelectomy with the new cord pulling technique in comparison with the standard microsurgical varicocelectomy. Patients and methods : The study included 60 patients either adults with clinically palpable varicocele who sought treatment for infertility and impaired semen quality or pain not responding to medical treatment or adolescents with clinically palpable varicocele . In all cases, clinical examination was confirmed by scrotal duplex. They were randomly assigned to either microsurgical subinguinal varicocelectomy with the standard technique or the cord pulling technique with 31 patients in the 1st group and 29 patients in the second group between December 2018 and March 2020 in King Fahd Unit of the Urology department in Cairo university hospitals.Surgical success was defined as sparing the vas deferens and preserving at least 1 artery and 1 lymphatic duct in addition to ligation of the veins. The microsurgical operative time was calculated A Leica M690 Heerbrugg, Switzerland surgical microscope was used with 8-12 times magnification Patients were followed up postoperatively at 1 and 3 months by Examination , scrotal duplex for clinically palpable varicocele & Semen analysis at the 3- month follow-up for surgeries done for impaired semen parameters. Postoperative clinical success after treatment of primary varicocele by microsurgical varicocelectomy is defined as increase in total motile sperm count or return of sperm to ejaculate in Non-obstuctive azospermia patients , improvement of pain , no clinically palpable varicocele or retrograde flow by scrotal duplex and finally spontaneous pregnancy in each group separately