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| The Effect of Four Surgical Approaches on the Semen Quality and Pregnancy Rate in Patients with Subclinical Varicocele |
| SU Hongwei, et al |
| The First Affiliated Hospital of Hebei North University, Hebei Zhangjiakou 075000, China |
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Abstract Objective: To investigate the effects of four different surgical methods for the treatment of subclinical varicocele. Methods: 235 patients in our hospital were randomly divided into 4 groups: Group A with 60 cases was treated with traditional trans inguinal canal operation, group B with 58 cases was treated with subinguinal microscopic varicocelectomy, group C with 62 cases was treated with inguinal microscopic spermatic vein ligation, group D with 55 cases was treated with laparoscopic spermatic vein ligation. The operation time and hospital stay of 235 varicocele patients were recorded, and the postoperative recovery, complications, recurrence rate, the quality of semen before and after operation, and the pregnancy rate were compared. Results: The operation time of group A was the shortest of the four methods, but the hospital stay was longer than other groups (P < 0.05). The symptoms of patients in each group were significantly improved after six months, while the improvement rate of group B was higher than that of group A and group D (P < 0.05), but no statistical difference was found when compared with group C. The complication rate and recurrence rate in group B were lower than those in the other groups. The sperm quality in each group were significantly improved after 3, 6 and 12 months, in which the sperm motility of group B was obviously better than others. The pregnancy rate of the spouses in each group were 23.33%, 41.38 %, 25.81%, 27.27% respectively. There was statistically difference in the conception rate in 12 months after the surgery between group B and the other three groups.Conclusion: The four kinds of surgical procedures can significantly improve the semen quality and conception rate. But the subinguinal microscopic varicocelectomy has obvious advantages in reducing the recurrence rate and improve the sperm quality and pregnancy rate of spouse, and it is worth recommending for clinical applications.
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| Fund:河北省张家口市科学技术项目,(编号:1421091D) |
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2017, Vol. 23 
