What are the surgical options?
|Surgical approach||Cost||Recurrence of varicocele||Improvement in Semen||Potential for Morbidity|
|1. Paloma’s (Retroperitoneal open approach)||++||Yes||20% to 30%||No|
|2. Laparoscopic approach||+++
Very high recurrence rate.
|20%||Serious morbidity possible.
No proven benefit.
|3. Microsurgical Trans Inguinal approach||+++||No||40% to 50%||No|
|4. Radiological balloon occlusion approach||++++||Maybe||30% to 40%||No|
|5. Cremasteric disruption with venous ligation||+||Nil||97% improvement in Semen.
Pregnancy rates observed by Dr. Parag Shah
64% pregnancy rate at one year
80% pregnancy rate at 2 years.
Low cost, ambulatory (walk-in, walk-out from operating table)
High success rate.
- The higher the approach, the higher the incidence of recurrence and low fertility rates.
- Laparoscopic Approach: Costly. Has potential for serious morbidity.