الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
Sumnuuy and Conclusion 122
SUMMAR)’ AND CONCLUSION
Varicocele IS undoubtedly incriminates as a cause of
subfertility.
The effect of testicular varicocele; and hence the effective
results of its ablation, varies according to the original seminogram.
Whether the original picture of the seminogram is the results of
only the varicocele or in combination with other, yet, unknown
factors is not clear, or it could be due to the duration which the
physician is never sure of
What is more puzzling is that some men have varicocele and
yet have normal seminogram, and effect normal pregnancy.
It has been proved that the presence of varicocele on one side
affects the function on the other side and this is possibly due to the
presence of collateral veins which can not be seen or detected by
the traditional operations.
A significant relationship between the preoperative testicular
volume and sperm density in varicocele patients has been found in
this series. The higher the decrease in preoperative sperm density,
the higher the loss of testicular volume.
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Sumnuuy and Conclusion 123
Laparoscopic varicocelectomy undoubtedly having the
advantage of detecting the collaterals and clipping them. This
certainly explains the overall better results of laparoscopic
varicocelectomy.
No significant relationship between the grade of varicocele
and the preoperative or postoperative seminal parameters has been
found, for patients with sperm count > 10X 106/ml.,not only in
both groups collectively but also in every group separately.
Bilateral varicocelectomy give superior results than unilateral
varicocelectomy even if there is no apparent collaterals, and the
contralateral side is not clinically evident and hardly detected by
Doppler examination which is, often all, a subjective test.
Varicocelectomy in patients with sperm density less than ten
millions in some cases gives statistically better results but still less
than ten millions. Those patients should always have preoperative
serum measurements of FSH and testosterone. If it is primary
testicular failure, varicocelectomy is not indicated.
The best results of varicocelectomy is obtained when the
preoperative sperm density is more than ten millions.
Laparoscopic varicocelectomy should be considered superior
to the classical approach because collateral veins are seen visually
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Sumnuuy and Conclusion
124
and clipped. The laparoscopic approach also allows for accurate
identification of the anatomy; artery, vas, vein and collaterals, thus
minimizing the risk of injury of these Structures.
Bilateral laparoscopic varicocelectomy can be done through
the same ports.
Morbidity of the laparoscopic procedure is less and the
resumption to normal activity is quicker than with the traditional
approach.
In conclusion : laparoscopic Varicocelectomy adds a new
surgical approach with several advantages over the classical
operations.