Microscopic Versus Laparoscopic Varicocelectomy In The Treatment Of Varicocele: The Changes Of Sexual Hormones After Operation

Objective:To explore the curative effects of microscopic subinguinal varicocelectomy(MV) and laparoscopic varicocelectomy (LV) for varicocele by evaluating postoperativechanges of sexual hormones and semen quality.Methods: We retrospectively analyzed the clinical data of96varicocele patientstreated by microsurgical varicocelectomy from August2012to August2013in the firstaffiliated hospital of Soochow University. Sperm motility，sperm density，testosterone,follicle-stimulating hormone (FSH) and leuteinizing hormone (LH) in all patients wereexamined before and3months after the operation. The changes of sperm motility，spermdensity and sex hormone level before and after the operation were summarized andanalyzed.78patients diagnosed with gradeⅡ varicocele were divided into two groups:group1(39patients) was performed by MV and group2(39patients) underwent LV.Thechanges of sex hormone level before and after the operation were summarized andanalyzed.Results: Most patients underwent MV (78.2%) had lower level of serum testosterone(2.94±0.53) than lower limits of normal (≤4.2ng/mL). The level of serum testosterone of85patients increased (88.54%).79patients (82.29%) had an improvement in semenparameters. The level of serum testosterone increased from （3.75±1.30） ng/ml to（4.15±1.24）ng/ml by an average of （0.40±0.28）ng/mL （P＜0.05）3months afteroperation. Sperm motility（a+b）increased from （41.13±5.18）%to （50.53±5.35）%（P＜0.05）.78.2%of78patients underwent MV or LV had lower level of serumtestosterone（2.94±0.53）ng/mL. For the MV group, the level of serum testosteroneincreased from （3.50±1.26）ng/ml to （3.86±1.13) ng/mL and (4.20±1.02) ng/mL threeand six months after the operation, separately. For the LV group, the level of serumtestosterone increased from （3.36±0.96）ng/mL to （3.70±0.92) ng/mL and (3.93±0.80) ng/mL three and six months after the operation, separately. The level of serum testosteroneafter the operation was significantly higher than before for the two groups (P＜0.05). Thelevel of serum testosterone increased significantly in the MV group than that in the LVgroup after operation（0.70±0.33/0.56±0.26）（P＜0.05）. However, there was no significantdifference among the two groups for the levels of FSH and LH (P＞0.05).Conclusion: MV can effectively improve semen parameters and level of serumtestosterone in varicocele patients, especially for those with lower level of serumtestosterone than lower limits of normal．The levels of serum testosterone of patients withgrade II varicocele were improved significantly after MV or LV. The patients can obtainmore benefits from MV than LV.