Comparison of Open Versus Laparoscopic High Ligation Varicocelectomy For The Treatment Of Varicocele

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.

Study Overview

• Status: Completed
• Conditions: Varicocele
• Intervention / Treatment: Procedure: Open high ligation varicocelectomy; Procedure: Laparoscopic high ligation varicocelectomy

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Lahore General Hospital, Lahore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group A (Open high ligation varicocelectomy); Open high ligation varicocelectomy	Procedure: Open 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.
Active Comparator: Group B (Laparoscopic high ligation varicocelectomy); Laparoscopic high ligation varicocelectomy	Procedure: Laparoscopic 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean operative time	Operative time was measured in minutes from skin incision until completion of skin closure (stitching).	During the surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of hospital stay	Hospital stay was measured in days from the day of surgery until discharge from the hospital.	Up to 30 days post-surgery
Wound infection rate	Wound infection was assessed at 10 days after surgery with confirmation by positive pus culture when discharge was present.	10 days after surgery

Collaborators and Investigators

• Sponsor: Lahore General Hospital
• Investigators: Principal Investigator: Muhammad Zeshan Aziz, Lahore General Hospital, Lahore

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2024
• Primary Completion (Actual): November 30, 2025
• Study Completion (Actual): November 30, 2025

Study Registration Dates

• First Submitted: January 9, 2026
• First Submitted That Met QC Criteria: January 15, 2026
• First Posted (Actual): January 20, 2026

Study Record Updates

• Last Update Posted (Actual): January 20, 2026
• Last Update Submitted That Met QC Criteria: January 15, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Laparoscopic surgery; Postoperative wound infection; Open surgery; High ligation; Varicocelectomy
• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Vascular Diseases; Cardiovascular Diseases; Postoperative Complications; Pathologic Processes; Genital Diseases, Male; Male Urogenital Diseases; Infections; Wound Infection; Pathological Conditions, Signs and Symptoms; Surgical Wound Infection; Varicocele
• Other Study ID Numbers: LahoreGeneralH13

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No