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Abstract To investigate the efficacy of retroperitoneal high ligation, laparoscopic, or microscopic surgery for treating sterility patients with varicocele, and to study their correlation with the age of the patients. Methods: 117 sterility patients with varicocele aged 22-39 years old were enrolled and were divided into three groups according to different surgical methods from January 2015 to July 2019. 35 patients in group A received retroperitoneal high ligation, 42 patients in group B received laparoscopic surgery, and 40 in group C received microscopic surgery. The patients in each group were further divided into two subgroups according to their ages, which included 20 patients with 22-39 years old in group A1, 23 patients with 22-39 years old in group B1, 23 patients with 22-39 years old in group C1, 15 patients with 31-40 years old in group A2, 19 patients with 31-40 years old in group B2, and 17 patients with 31-40 years old in group C2. The preoperative indexes of the patients in these groups were recorded. And the semen of the patients in these groups was collected in 30 days before surgery and in 12 month after surgery for analysis. Results: The operation time and the postoperative hospital stay time of the patients in group A were significantly higher than those of the patients in group B and group C, and the hospitalization cost and the postoperative blood loss of the patients in group A were significantly lower than those of the patients in group B and C. The postoperative gastrointestinal function recovery time of the patients in group A was significantly lower than that of the patients in group B (P<0.05). 12 months after surgery, the sperm motility and concentration of the patients in these groups were significantly higher than those before surgery, and the sperm malformation rate of the patients in these groups was significantly lower than that before surgery. The sperm motility and concentration of the patients in group C1 and group C2 were significantly higher than those of the patients in group A1, group A2, group B1, and groupB2, the sperm motility of the patients in group B1 and group B2 was significantly higher than that of the patients in group A1 and group A2, and the sperm malformation rate of the patients in group C1 and group C2 was significantly lower than that of the patients in group A1, group A2, group B1, and group B2 (all P<0.05). There was no significant correlation between the postoperative semen quality improvement of the patients in these groups and their age (P>0.05). There were no significant differences in the incidences of postoperative complications and recurrence of varicocele of the patients among group A, among B, and among C (P>0.05). After 2 years, the pregnancy rate of the spouse of the patients in group A was significantly higher than that of the patients in group B and group C (P<0.05). Conclusion: Retroperitoneal high ligation, laparoscopic, and microscopic surgery can treat the sterility patients with varicocele, and the comprehensive curative effect of microscopic surgery has the best efficacy. There is no significant correlation between the postoperative semen quality improvement of the patients and their age.
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