https://doi.org/10.4081/aiua.2023.11008

Intraoperative hydrodissection and Doppler ultrasound during magnified varicocelectomy: A comparative study

Vol. 95 No. 1 (2023)
Submitted: November 13, 2022
Accepted: December 24, 2022
Published: February 22, 2023
Intraoperative Doppler, Hydrodissection, Magnified subinguinal varicocelectomy, Infertility, Varicocele
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Authors

Salah E. Shebl
salahshebl@yahoo.com
https://orcid.org/0000-0003-2418-0803
Urology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Saadelddin Ali
Dermatology and Andrology Department, Al-Azhar University, Cairo, Egypt.
Ahmed El Gammal
Urology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.

Methods: We performed a non-randomized comparative trial that recruited infertile men with varicocele who were scheduled to undergo MSV. Eligible patients were allocated by the investigators in a 1:1 ratio to receive intraoperative Doppler (group I) or intraoperative Doppler plus hydrodissection (group II).

Results: Sixty men were included in each group. The two study groups showed a comparable number of ligated veins on the right (4.22 ±1.57 versus 4.42 ± 1.65; p = 0.49) and left side (6.77 ± 2.14 versus 6.98 ± 2.29; p = 0.59). On the contrary, group II showed a significantly higher number of preserved arteries on the right (2.42 ± 0.56 versus 1.47 ±0.5 in group I) and left side (2.6 ± 0.53 versus 1.63 ± 0.55 in group I), with p-value < 0.001. The sperm motility was significantly higher in group II than in group I (21.25 ± 13.73 versus 13.85 ± 12.25, respectively; p = 0.002). In both groups, the sperm motility increased significantly at the end of follow-up compared to the preoperative period. The postoperative sperm mortality remained significantly higher in group II than in group I (p = 0.008).

Conclusions: Intraoperative Doppler plus hydrodissection (D+IH-MSV) has advantages in preserving more arteries and enhancing the motility of sperms. Based on these findings, we strongly recommend D+IH-MSV when treating infertile men with varicocele.

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How to Cite

Shebl, S. E., Ali, S., & El Gammal, A. (2023). Intraoperative hydrodissection and Doppler ultrasound during magnified varicocelectomy: A comparative study. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11008
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