Keywords
varicocelectomy
laparoscopy
microsurgery
male infertility
How to Cite
Abstract
Background. Varicocele is the most common surgically correctable cause of male infertility, yet the choice of surgical technique remains a matter of ongoing debate. Open (Ivanissevich-type), laparoscopic, and microsurgical subinguinal approaches each carry distinct profiles of recurrence, hydrocele formation, postoperative pain, and recovery. We report a small, single-centre comparative experience and place it within the contemporary evidence base.
Methods. Between January 2024 and January 2026, 16 male patients (aged 18–46 years) undergoing varicocele repair at the Clinical Hospital of Tetovo were studied. Eight were treated with a laparoscopic technique and eight with a conventional open technique. Outcomes recorded were intra- and postoperative complications, postoperative pain, hydrocele formation, time to full recovery, and varicocele recurrence.
Results. No complications were recorded in the laparoscopic group; one patient in the open group developed a postoperative haematoma. Postoperative pain was clearly lower after laparoscopy, and full recovery was shorter than after open surgery. No hydrocele was observed in either group. A mild recurrence occurred in one laparoscopic patient and in one open patient, the latter being more pronounced.
Conclusions. In this limited series, laparoscopic repair was associated with less pain and faster recovery than open repair, with comparable short-term safety. These observations are consistent with the broader literature, in which microsurgical subinguinal varicocelectomy currently shows the lowest recurrence and hydrocele rates and is regarded by many andrology centres as the surgical reference standard. The small sample size precludes firm conclusions, and larger comparative work is needed.
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