Microsurgical versus Conventional Inguinal Varicocelectomy: A Systematic Review of Fertility Outcomes and Recurrence Risk

Putra, Bobby Aksanda
Sibarani, Benly Levi Andreas
Sinaga, Maeike Grestiana

Asian Journal of Healthcare Analytics
Vol. 4 No. 2 (2025): November 2025

Infertility affects 8–12% of couples, with varicocele being the most common correctable male factor. Microsurgical subinguinal varicocelectomy offers better reproductive results than conventional or laparoscopic techniques. To compare fertility outcomes and recurrence rates between microsurgical and conventional varicocelectomy (2020–2025). A systematic review of 371 articles identified 9 eligible studies assessing semen quality, pregnancy rate, hydrocele, and recurrence. Microsurgical varicocelectomy showed greater improvements in semen parameters and natural pregnancy rates, along with lower hydrocele and recurrence. Sperm count increased by 7.7 ± 4.5 million/mL. Microsurgical subinguinal varicocelectomy is safer and more effective, and remains the preferred approach for varicocele management in infertile men.