Pooja Pandey, Akanksha Akanksha, Shyamendra Pratap Sharma, Irfan Khan, Sandesh B. Singh

A PROSPECTIVE ANALYSIS OF THE COMPARISON OF OUTCOMES BETWEEN LAPAROSCOPIC VARICOCELECTOMY AND PALOMO'S CONVENTIONAL METHOD IN THE MANAGEMENT OF CHRONIC SCROTAL PAIN- A RURAL TERTIARY CARE CENTRE EXPERIENCE.

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Background: The scrotal temperature is 2 degrees Celsius lower than the body temperature, which helps men to maintain fertility. Varicocele disrupts the thermoregulatory mechanism of the scrotum, resulting in infertility. Patients do present with chronic scrotal pain, but the exact mechanism behind it is unknown. Various treatment options are available for its treatment, ranging from noninvasive to invasive Aim and Objective: To compare the outcomes in terms of age , body mass index, intraoperative difculties , post-operative pain, requirement of analgesics, complications, duration of hospital stay, and recurrence between Palomo's varicocelectomy and laparoscopic varicocelectomy. Material and Methods: A prospective study has been conducted for 1 year, from October 2021–September 2022, on 20 patients clinically diagnosed as having primary varicocele and divided randomly into two groups. Group A is for the Palomo's and Group B is allocated for laparoscopic varicocelectomy. After receiving clearance from the Institutional Ethical Committee, this study is being conducted in the Department of General Surgery, MIMS, and Uttar Pradesh. The preoperative mean duration of pain is 10.5 months, and the mea Result: n age of occurrence of varicocele is 38.33±3.3.Group B have more obese patients where easily the pampiniform plexus has been reached with minimum destruction of lymphatic and hence only 1 patient of this group has developed hydrocele .Surgeons in an Open approach i.e Group A have faced difculty while operating on post operated hernia patients with varicocele where dense adhesions have been encountered along with an increase in operating time. Pain is measured using a visual analogue scale, which in Group B is zero after 9 months of follow-up but one in Group A. The complication occurs more frequently in Group A than in Group B.In this study Palomo's varicocelecto my has a high recurrence rate. Laparoscopic Conclusion: varicocelectomy is the most effective technique as shown on visual analogue scale for pain in patients with bilateral varicocele, obese and those in whom dense adhesions can be expected, such as post-repair inguinal hernia patients. Further randomized controlled trials are needed to establish a consensus on the safest and most effective method of treatment of varicocele

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