الفهرس Only 14 pages are availabe for public view
 |  | from | 114 |  |  |
| | | from | 114 | | |
Abstract
In this study, the anatomy of male reproductive organs, the pathogenesis of varicocele and its relation to the infertility, the clinical picture and the different diagnostic modalities, as well as the treatment of varicocele were revised. This thesis was studied in the department of General Surgery in Zagazig University Hospital including 40 patients with varicocele and having an indication for surgery in the form of subfertility. They were divided into two groups randomly (each group contains 20 patients). In first group, the ordinary open method (retroperitoneal high ligation) was applied, whereas in second group, laparoscopic varicocele ligation was done.
All patients were subjected to full clinical examination, semen analysis, colour Duplex studies and hormonal profile.
In our study, the laparoscopic procedure takes a shorter time than the open one. Since the varicocele occurs commonly in young and active population (mean age, 31 years), the short hospital stay and rapid return to work in laparoscopic group are very important economic advantages.
Hydrocele and recurrence were higher in open group (15%), (15%) than laparoscopic one (5%), (0%) respectively. Also, the laparoscopic group complications in the form of shoulder tip pain (10%) and pneumoscrotum (5%) were temporary.
There was a little difference between the two groups as regards the improvement of semen parameters.
Pregnancy rate was higher in laparoscopic group (25%) than open one (15%In bilateral varicocelectomy using laparoscopy can be achieved via the same ports, instead of two incisions required in high ligation approach, so laparoscopic approach is cosmetically better than open one.
In conclusion, laparoscopic varicocelectomy has minimal postoperative complications as regards hydrocele, testicular atrophy and recurrence.
The laparoscopic ligation of testicular veins is too high which makes the testicular ischaemia is nil and secondary hydrocele is minimal. Laparoscopic varicocelectomy is cosmetically better than open high ligation which needs bigger incisions to reach the retroperitoneal testicular veins.
Laparoscopic varicocelectomy does not need special equipments so, the cost is minimal.