Varicocele Treatment: Angiographic embolization versus varicocelectomy

Varicocele is a dilatation of the pampiniform plexus of the testicular veins, the varicocele repair has been shown to reverse a spectrum of effects contributing to men with impaired fertility, it can be treated either by surgical ligation or angiographic occlusion of the spermatic veins. The aim of this study is to compare the outcome of percutaneous varicocele embolization versus surgical ligation with regard to changes in semen parameters. In this retrospective study, a total of 61 patients underwent varicocele correction. The patients were divided into two groups according to the treatment procedure; group (A) 31 patients treated by angiographic embolization of the spermatic vein and group (B) 30 patients treated by surgical ligation. The semen analysis of both groups was reviewed pre-treatment and one year after treatment for volume (ml), concentration (Sperm x10 per ml), motility (% motile), morphology (% normal shape) and total motile sperm count (TMSC) (Sperm x10). The t-test was used to measure levels of statistical significance. The mean age for group (A) was 28 years old ranged between (19-41 years) and 28.83 years ranged between (20-43) for group(B). After one year follow-up, when comparing the semen parameters pre and post-treatment for each group separately, it has been found a significant improvement in concentration, motility and TMSC for both groups P. values ≤ (0.05). The morphology improved significantly in group (A) P. value≤ (0.05), but not quite significant in group (B) P. value = (0.16). No significant improvement was noted in the volume of ejaculate for both groups P. values = (0.7829) and (0.2486) for group (A) and group (B) respectively. During one year follow-up it has been found that the two methods were successfully improved the semen parameters with no significant differences between them, thus improving the fertility in terms of sperm parameters. Considering the advantages of angiographic embolization technique of being low cost, no general anesthesia, short hospital and recovery times, it is more recommended than the surgical technique.