To investigate the effect of different surgical procedures on semen quality, prognosis and safety in patients with varicocele.

A total of 118 patients with varicocele admitted to our hospital from September 2015 to December 2018 were selected by random sampling method. According to different treatment methods, they were divided into research group (n=47), traditional group (n=28) and microscope group (n=43). The traditional group was treated with traditional laparoscopic surgery, the research group was treated with suprapubis-assisted umbilical mini-daul-site laparoscopic internal spermatic vein high ligature, and the microscope group was treated with microscope ligation of internal spermatic vein. The semen quality, resting state maximum diameter of spermatic vein (DSR) in supine position, postoperative complications, postoperative pregnancy rate of partners and follicle stimulating hormone (FSH) levels were compared between the three groups before and after surgery.

The sperm density, sperm motility and percentage of normal sperm in each group after operation were higher than those before operation (all P<0.05), while DSR was lower than those before operation (P<0.05). There were significant differences in sperm density, sperm motility and DSR among the study group, the traditional group and the microscope group (all P<0.05). There was no significant difference in the incidence of scrotal edema, testicular hydrocele, local nerve injury and acute epididymitis among the three groups (all P>0.05). The comparison of spouse pregnancy rate 12 months after operation among the three groups showed that the study group and the microscope group were higher than the traditional group, but the difference was not statistically significant (P>0.05). The levels of FSH in the three groups were significantly improved, and the improvement degree of the study group and the microscope group was better than that of the traditional group (all P<0.05).

Suprapubis-assisted umbilical mini-daul-site laparoscopic internal spermatic vein high ligature of varicocele and microscopic ligation of varicocele can effectively improve the semen quality and prognosis of patients with varicocele with fewer postoperative complications. In addition, the incision of transumbilical surgery is more subtle and aesthetic than that of microscopical ligation, which is worthy of clinical application.

Varicocele; Surgical Procedures, Operative; Semen