Efficiency and safety of microscopic cluster ligation of the internal spermatic veins: A prospective matched case-control study

Introduction: The aim of this study was to evaluate the surgical efficacy and safety of microscopic cluster ligation of the spermatic vein (MCLSV), and to compare the similarities and differences between MCLSV and microscopic traditional branch ligation of the spermatic vein (MTBLSV). Material and methods: A prospective matched case-control study of 91 patients with bilateral varicocele was conducted. Participants underwent microscopic bilateral spermatic vein ligation and were randomly assigned by computer to undergo MCLSV on one side and MTBLSV on the other. The operative outcomes of the two techniques were compared. Results: The operative time of MCLSV was significantly lower than that of MTBLSV (p <0.001). Postoperative day 1 VAS scores at the operative site in MCLSV were significantly lower than MTBLSV (p <0.05). There was no significant difference between the two groups in the number of spermatic vein ligations, the number of internal spermatic arteries and lymphatics, complications, occurrence of foreign body sensation of wire knots, improvement of scrotal pain and distant recurrence (p >0.05). Conclusions: Compared with MTBLSV, MCLSV can significantly shorten surgical time, improve surgical efficiency, and alleviate postoperative perineal pain and discomfort in patients while ensuring surgical safety and effectiveness.