Comparison of The Efficacy and Safety of Palomo, Ivanissevich and Laparoscopic Varicocelectomy in Iranian Infertile Men with Palpable Varicocele

BACKGROUND: This study aimed to compare the effects of three commonly used varicocelectomy techniques namely, open retroperitoneal ligation (Palomo), open inguinal ligation (Ivanissevich) and laparoscopy, in Iranian infertile men. MATERIALS AND METHODS: This retrospective study was conducted on 70 infertile men with palpable varicocele who underwent one of the varicocelectomy techniques namely, Palomo, Ivanissevich, or laparoscopy. Basic information about semen parameters were collected and registered prior to the surgery. Three months after the surgery, semen parameters and surgical complications were investigated in all patients. RESULTS: The Palomo technique was significantly associated with fewer complications compared to other techniques (P=0.006). The means of sperm concentration, normal motility and normal morphology were significantly different among the three groups after surgery (P=0.025, 0.023 and 0.047, respectively). However, after adjustment for potential confounders, in addition to the baseline values of semen parameters, significant differences were observed only in sperm concentration among the groups (P=0.040). CONCLUSION: Varicocelectomy improved sperm parameters. The Ivanissevich technique was more effective in improving sperm concentration compared to the laparoscopic method. The lowest rates of complications were related to the Palomo technique.