The use of titanium ligation clips in microsurgical subinguinal varicocelectomy

Objective: The aim of this study is to evaluate the use of titanium ligation clips for dilated spermatic veins in microsurgical subinguinal varicocelectomy. Material and methods: In this retrospective study, eighty-four men with clinical varicocele underwent microsurgical varicocele repair. The patients were divided into two groups according to the ligation materials used for the varicocelectomy (silk sutures vs. titanium clips). Group 1 included 43 patients; these patients underwent microsurgical subinguinal varicocelectomy with the titanium clips. The 41 patients included in Group 2 underwent microsurgical subinguinal varicocelectomy with silk sutures. Microsurgical subinguinal varicocelectomy was performed in all patients. The two study groups were compared in terms of intra-operative and postoperative parameters. Results: The mean age of the patients was 28.6±4.6 years, and the mean follow-up was 12.3±2.7 months. The two groups exhibited comparable improvements in sperm motility and/or concentration: 79.1% and 82.9% in Group 1 and Group 2, respectively (p>0.05). The operation time in Group 1 (titanium clip) was significantly shorter than in Group 2 (silk sutures). None of the patients experienced any intra-operative complications. There were no significant differences between Group 1 and Group 2 with regard to postoperative recurrences, ligated veins, postoperative complications and hydrocele formation, hospitalization time, the requirement for postoperative analgesia or the time until the patient could return to work. Conclusion: Titanium ligation clips can be used for the ligation of dilated vessels during microsurgical subinguinal varicocelectomy, and the operation time is significantly reduced with the use of titanium ligation clips.