Is unilateral varicocelectomy as effective as bilateral varicocelectomy in management of subfertile patients with bilateral varicocele

Objectives: To compare the results of unilateral and bilateral subinguinal varicocelectomy for patients with primary infertility, including sperm parameters and pregnancy rate.Patients and method: This a retrospective study including 91 men with primary subfertility with bilateral varicocelectomy. The patients were divided into two groups. Group A (46 patients) were subjected to bilateral varicocelectomy. Group B (45 patients) subjected to left varicocelectomy. Patients with unilateral, recurrent, subclinical, secondary varicocele and azoospermia were excluded. All Patients were evaluated with at least two semen analyses with 15 days apart. Follow up schedule for all patients includes physical examination and semen analysis 3, 6, and 12 months postoperatively.Results: Subinguinal varicocelectomy with loup magnification was successfully performed in all 91 patients, with no intra-operative complications occurred. The age ranged between 25 and 39 years (average 32 years),which was not significantly different within the 2 groups. The mean follow up was 7 months. Neither definite hydrocele nor testicular atrophy was detected. Despite considerable changes were noted in sperm concentration, percentage of motility and normal sperm morphology postvaricocelectomy in both groups, there was not a statistically significant difference between the two groups, (P = 0.139, 0.922, and 0.825, respectively and also pregnancy rate (P = 0.14).Concolusions: The semen parameters and pregnancy rate improved significantly in patients who underwent unilateral and bilateral varicocelectomy, with no significant difference between the two groups