Surgical Evaluation of Open Subinguinal and Microscopic Varicocelectomy for Improvement of Semen Quality and Post-Operative Complication

Ahmed A.  Essa; Issam  Salman  Habib   Al-Azzawi; Ahmad Hamza  Al-Zubaidy

doi:10.17605/cajmns.v6i3.2845

Ahmed A. Essa College of Medicine, Al-Iraqia University
Issam Salman Habib Al-Azzawi Al-Mustansiriya Medical College
Ahmad Hamza Al-Zubaidy Al-Mustansiriya Medical College

DOI: https://doi.org/10.17605/cajmns.v6i3.2845

Keywords: Varicoceles, Microscopic Varicocelectomy, Subinguinal Varicocelectomy, Seminal fluid analysis.

Abstract

Varicocelectomy remains one of the most commonly performed surgeries in urological practice to address male infertility, typically caused by dilated spermatic veins. This study presents a prospective comparative analysis of two surgical approaches—microscopic subinguinal and conventional subinguinal varicocelectomy—to evaluate their effectiveness in improving semen quality and minimizing postoperative complications. Over a two-year period, 106 patients with palpable varicoceles and abnormal semen parameters were assigned to two groups: one underwent microsurgical varicocelectomy using a microscope, while the other received conventional subinguinal surgery. Semen analysis and clinical evaluations were conducted preoperatively and during follow-up. Both surgical techniques demonstrated statistically significant improvements in seminal fluid parameters, such as sperm concentration, motility, and morphology, with no notable differences in the magnitude of enhancement between the groups. However, the microsurgical method required more operative time. Postoperative complications in both groups were minimal, with manageable side effects such as scrotal swelling and mild pain. The findings affirm that both methods are safe and effective, with the microsurgical approach offering a slight advantage in precision and fewer complications when equipment and expertise are available. In resource-limited settings, conventional varicocelectomy remains a valid and cost-effective alternative

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