Postoperative Complications of Laparoscopic versus Open Varicocelectomy

Background: Varicocele, characterized by the dilation and swelling of testicular veins, significantly impacts male infertility and semen quality, affecting 10-15% of the male population. Surgical intervention is essential to alleviate these effects, with various techniques available, including laparoscopic and open subinguinal varicocelectomy. Objective: This study aimed to compare postoperative complications between laparoscopic and open subinguinal varicocelectomy to determine the superior approach in terms of patient outcomes and complications. Methods: A randomized controlled trial was conducted, involving 130 patients admitted to Hayatabad Medical Complex, Peshawar, from November 10, 2021, to July 31, 2022. Participants, presenting with symptoms of scrotal heaviness, testicular swelling, pain, and infertility, were randomly assigned to either the laparoscopic (Group L, n=70) or open subinguinal (Group O, n=60) varicocelectomy groups. Preoperative assessments included medical history, clinical examination, and necessary tests. Informed consent was obtained from all participants. Exclusion criteria included patients with malignancy, diabetes (BSR > 200 mg/dl), or unstable hemoglobin levels (Hb < 10 mg/dl). Postoperative complications, including wound erythema, hydrocele, epididymitis, and bruising, were documented and analyzed using SPSS version 25, with a significance level set at P ≤ 0.05. Results: The mean age of Group L was 27.3 years (±2.3), and Group O was 25.2 years (±3.5) (P = 0.042). Postoperative complications were significantly lower in Group L compared to Group O. Wound erythema was observed in 1.42% of Group L and 8.3% of Group O (P = 0.05). Hydrocele occurred in 2.8% of Group L versus 10% of Group O (P = 0.04). Epididymitis was found in 1.42% of Group L and 6.5% of Group O (P = 0.03). Bruising was noted in 1.66% of Group O, with no cases in Group L (P = 0.05). Conclusion: Laparoscopic varicocelectomy resulted in fewer postoperative complications compared to open subinguinal varicocelectomy, making it the preferred surgical approach for varicocele treatment. Further studies with larger sample sizes and long-term follow-up are recommended to validate these findings.