To compare and analyze the clinical effects of three surgical approaches under the microscope in the treatment of varicocele.

The data of 88 patients with varicocele ligation in the Second Affiliated Hospital of Soochow University from March 2017 to February 2019 were analyzed retrospectively. All patients underwent microsurgical varicocele ligation. The operation was performed by the same team of surgeons. According to the different surgical approaches, the patients were divided into three groups. Group I (n=14) was retroperitoneal incision, group II (n=48) was incision through the inguinal region, and group III (n=26) was incision through the outer ring. The operation time, number of ligation veins, recurrence rate, improvement of semen quality, VAS score (visual analogue scale/score) and short-term postoperative complications were compared in the three groups.

The operation time and the number of ligature vein branches in group III were significantly more than those in group II (P<0.05); the semen quality of the three groups after operation was better than that before operation (P<0.05); the postoperative VAS score was lower than the preoperative score (P<0.05). However, there was no significant difference of short-time complications, postoperative recurrence rate, relief of scrotal pain, sperm motility and morphological improvement among the three groups (P>0.05).

Microsurgical spermatic vein ligation can improve the quality of semen and relieve scrotal pain. Clinically, in order to obtain good clinical results, the appropriate surgical approach should be selected according to the actual situation of the patient to complete the operation.