Varicocele
Conditions
Keywords
Varicocelectomy, High ligation, Open surgery, Laparoscopic surgery, Postoperative wound infection
Brief summary
Varicocele is a common condition in which veins around the testis become enlarged, and it may be associated with scrotal discomfort and reduced fertility. Surgical treatment aims to stop the backward flow of blood in these veins so that the testicular environment improves. This randomized controlled trial was conducted in the Department of Urology, PGMI, Lahore General Hospital, Lahore, over a six-month period. Male patients aged 20 to 60 years with diagnosed varicocele and planned varicocelectomy under general anesthesia were enrolled after informed consent. Patients with recurrent varicocele, secondary varicocele, associated undescended testis, or a history of orchidopexy were excluded. Eligible participants were allocated into two groups using a lottery method. In Group A, high ligation was performed by the open method through a lower abdominal incision, with identification and ligation of the dilated testicular veins at a high level. In Group B, high ligation was performed laparoscopically using three small ports, with the testicular vein identified, clipped, and divided. Standard perioperative care was provided, including intravenous antibiotics and postoperative analgesia. The study compared the two techniques in terms of mean operation time , length of hospital stay , and wound infection . The hypothesis was that a difference existed between open and laparoscopic high ligation varicocelectomy regarding operation time, hospital stay, and wound infection.
Interventions
PROCEDUREOpen high ligation varicocelectomy
High ligation of the dilated testicular veins was performed by an open approach through a lower abdominal incision. The spermatic cord structures were approached extraperitoneally, the testicular vein was identified, separated from the artery after identification, and divided with ligatures. Wound closure was performed in layers with absorbable sutures and skin closure with silk sutures.
PROCEDURELaparoscopic high ligation varicocelectomy
High ligation of the testicular vein was performed laparoscopically by inserting three ports. The testicular vessels were approached intraperitoneally, the testicular vein was identified, clipped, and divided. Wound closure was performed using absorbable suture material, with skin closure using silk sutures.
Sponsors
Lahore General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
MALE
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Male patients age 20-60 years. * Patients with varicocele. * Planned to undergo varicocelectomy under general anesthesia.
Exclusion criteria
* Patients with recurrent varicocele. * Secondary varicocele. * Associated undescended testis or history of orchidopexy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean operative time | During the surgery | Operative time was measured in minutes from skin incision until completion of skin closure (stitching). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | Up to 30 days post-surgery | Hospital stay was measured in days from the day of surgery until discharge from the hospital. |
| Wound infection rate | 10 days after surgery | Wound infection was assessed at 10 days after surgery with confirmation by positive pus culture when discharge was present. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORMuhammad Zeshan Aziz
Lahore General Hospital, Lahore
Outcome results
None listed