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Abstract

Volume 19, Issue 2 (March 2017) 19, 214–218; DOI:10.4103/1008-682X.189622

The application of laparoscopic Doppler ultrasound during laparoscopic varicocelectomy in infertile men

Li-Qiang Guo1, Xiu-Lin Zhang1, Yu-Qiang Liu2, Wen-Dong Sun1, Sheng-Tian Zhao2, Ming-Zhen Yuan1

1 Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
2 Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033; Institute of Urology, Shandong University, Jinan, Shandong 250033, China

Correspondence: Dr. MZ Yuan (yuanmingzhen2005@126.com)

Date of Submission 25-May-2016 Date of Decision 04-Jul-2016 Date of Acceptance 26-Aug-2016 Date of Web Publication 27-Sep-2016

Abstract

The aim of this study is to evaluate the benefits of laparoscopic Doppler ultrasound (LDU) application during laparoscopic varicocelectomy (LV), and to compare the surgical outcomes and complications between LDU-assisted LV (LDU-LV) and conventional LV for infertile patients with varicoceles; 147 infertile patients were randomly divided into two groups. Operative and postoperative parameters, semen parameters, and the pregnancy rate were compared. There were no differences in baseline demographics. The operative time was significantly longer in LDU-LV group than LV group. The incidence of postoperative hydrocele was 1.4% (1/72) in LDU-LV group versus 10.7% (8/75) in LV group, which showed a significant difference (P < 0.05). However, other surgical outcomes, such as postoperative hospital stay, postoperative recurrence, and testicular atrophy, were similar between the two groups. Sperm concentration and sperm motility were significantly increased in both groups at 3, 6, and 12 months after surgery (P < 0.01), and they were higher in LDU-LV than LV group in 12 months after surgery (34.21 ± 6.36 vs 29.99 ± 6.04 for concentration, P < 0.05; 40.72 ± 8.12 vs 37.31 ± 6.12 for motility, P < 0.05). Sperm morphology was comparable between the two groups. The pregnancy rate showed no significant difference (44.4% of the LDU-LV vs 37.3% of the LV, P > 0.05). In conclusion, compared with LV, LDU-LV could safely and effectively ligate all spermatic veins and preserve spermatic arteries without leading to high varicocele recurrence and postoperative hydrocele. Given the benefits that sperm counts as well as sperm motility favoring LDU-LV, we recommend that LDU should be routinely used as an effective tool to improve outcomes and safety of laparoscopic varicocelectomy.

Keywords: Doppler ultrasound; laparoscopic varicocelectomy; varicocele

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