***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE We compared postoperative outcomes in patients treated with laparoendoscopic single site varicocele ligation with or without testicular artery and lymphatic preservation . MATERIAL S AND METHODS A total of 80 patients with left varicocele were r and omly divided into 2 groups and treated with laparoendoscopic single site varicocele ligation with preservation of the testicular artery and lymphatics ( 40 in group 1 ) or complete ligation of the testicular vessels and lymphatics ( 40 in group 2 ) . Operative time , hospital stay , return to normal activity , postoperative visual analog scale pain scores and complications were analyzed . In patients with subfertility preoperative and 3-month postoperative semen analyses were performed . In patients with scrotal pain preoperative and 12-month postoperative visual analog scale pain scores were analyzed . RESULTS A total of 35 patients per group completed the study .  Hospital stay , return to normal activity and postoperative pain scores did not differ between the groups . No major complications were observed . Mean ± SD operative time was 60.7 ± 10.7 and 48.6 ± 6.0 minutes in groups 1 and 2 , respectively ( p < 0.001 ) . Patients with subfertility , including 22 in group 1 and 21 in group 2 , showed improved semen parameters 3 months postoperatively but postoperative values did not differ between the groups . The 17 patients in each group with scrotal pain showed decreased pain scores 12 months postoperatively with no difference between the groups . CONCLUSIONS Laparoendoscopic single site varicocele ligation is feasible . No differences in postoperative outcomes and complications were observed when preserving or not preserving the testicular artery and lymphatics To evaluate , in a r and omized prospect i ve trial in children and adolescents , the feasibility of isosulphan blue‐based lymphatic vessel preservation during laparoscopic varicocelectomy  and its impact on the complication rate , as the operative management of varicoceles remains controversial A surgical method of varicocelectomy , in which the internal spermatic veins together with the testicular artery are ligated as a whole in the retroperitoneal space , has been proposed as a simple and reliable procedure . We evaluated the effects of ligating the testicular artery at varicocelectomy on fertility . A total of 34 subfertile patients with a left varicocele was r and omized into an artery-preserved or artery-ligated group  at open varicocelectomy  and the change in semen quality was prospect ively studied . The artery-preserved group showed improvements in sperm density and total sperm count , while the artery-ligated group showed improvements in sperm density , total sperm count and sperm motility . The results indicated identical improvement in semen quality in both groups of patients . Testicular volume , measured by a punched-out orchidometer , did not change in any of the patients in the ligated group , except for 1 with a grade 3 varicocele , although this decrease could not be detected by sonography . The effects of artery-preserving and artery-ligating varicocelectomy on postoperative pregnancy rates were investigated by examining 116 patients retrospectively . The pregnancy rates of 37.8 % and 23.8 % in the artery-preserved and artery-ligated groups , respectively , were not significantly different . Despite the theoretical advantage of artery preservation , our study did not show any significant difference between artery-preserving varicocelectomy and the artery-ligating operation when improvements in semen quality and postoperative pregnancy rate were evaluated Objective : To prospect ively compare the recurrence rate and short postoperative outcome after r and omized laparoscopic varix ligation with internal spermatic artery ( ISA ) preservation versus laparoscopic varix ligation with ISA ligation . Material and methods : Twenty-five patients with 35 varicocele who required varix ligation for infertility in 13 patients , scrotal pain in 15 patients and scrotal swelling in 2 patients who underwent one of two procedures :  laparoscopic varix ligation with ISA prservation ( Group A ) or laparoscopic varix ligation with ISA ligation ( Group B ) were postoperatively evaluated for short post operative outcome and underwent percutaneous spermatic venograms to detect recurrence . Fisher 's Exact Test was used for statistical analysis . Results : Recurrence through parallel collaterals was noted in 39 % and 5.9 % in Group A and Group B respectively as demonstrated on percutaneous spermatic venous venography ( PSV ) ( statistically significant p = 0.0408 ) . Preoperative pain completely resolved in all patients in Group B and persisted in 45 % in Group A. However , this was not statistically significant ( p = 0.088 ) . No testicular atrophy or hydrocele formation was noted in either group . Conclusions : Laparoscopic varix ligation with ISA ligation has lower recurrence rate than laparoscopic varix ligation without ISA ligation and may provide better varicocele related pain control with no increase in hydrocele or testicular atrophy rate . We recommend ISA ligation routinely during laparoscopic varix ligation Objectives : Testicular blood supply and semen quality were compared in two groups of patients undergoing laparoscopic varicocelectomy : group I ( n = 27 ) with spermatic artery ligation and group II ( n = 48 ) with spermatic artery preservation .  Methods :  Laparoscopic varicocelectomy  was performed on 75 patients divided on the basis of whether ligation took place during surgery or not . The blood flow parameter ( resistance index – RI ) measured using color Doppler sonography was the index of vascular efficiency selected . Results : Mean RI was 0.69 in group I and 0.65 in group II . The difference was not significant . Both groups showed improvements in sperm density and motility but there was no significant difference between groups for either parameter . Conclusion : Using color Doppler sonography confirms that ligation of the testicular artery during varicocelectomy does not lead to major changes in testicular blood supply or sperm quality The aim of this prospect i ve study was to assess long-term functional results ( spermiograms ) in subjects who underwent laparoscopic varicocelectomy via either of 2 procedures ( ligation or preservation of testicular artery ) . A total of 122 patients underwent laparoscopic varicocelectomy performed via either of the 2 different procedures : complete ligation of the spermatic vessels or preservation of the spermatic artery . After surgery when patients achieved 18 years , they were asked to undergo semen analysis . Spermiogram results were divided into 2 subgroups : " normal " and " abnormal . " We analyzed volume , sperm count per mL , percentage of motile spermatozoa , percentage of normal spermatozoa , and percentage of vitality for each group . Both groups showed the same results in terms of " normal " and " abnormal " spermiograms ( World Health Organization criteria ) , but analysis showed higher sperm concentration per mL , sperm motility , volume , vitality , and rate of morphologically normal sperm for the group with arteries preserved and " normal " spermiograms ( P < .01 ) . Analysis of data from the spermiograms showed that preservation of the testicular artery was the best possible option in terms of semen quality . Therefore , we believe that surgical treatment of varicocele should be carried out using procedures involving artery preservation PURPOSE There is evidence that varicocele damage , as reflected by loss of testicular mass , is most striking in the pubertal age group . We attempted to evaluate the long-term effect of early varicocele treatment on testicular growth and sperm count and , thus , determine its prophylactic value . MATERIAL S AND METHODS We compared testicular mass and sperm count in 32 men ( mean age 28 years ) who underwent surgery for varicocele at 11 to 15 years old ( mean age 13 ) to those in 26 untreated , age matched men ( mean age 30 years ) with varicocele and 27 male controls ( mean age 25 years ) . Mean followup in the treated group was 14.5 years ( range 12 to 20 ) . Testicular volumes were measured by ultrasonography . RESULTS There was no significant difference between left and right testicular volumes in the treated or control group , in contrast to the untreated group , in which the left testicles were significantly smaller . Comparison of testicular mass showed a striking similarity between the treated and control groups , while there was a significant difference when the untreated group was compared to the control and operated groups . Total sperm counts were significantly less in the untreated than the treated and control groups . CONCLUSIONS These data support the notion that testicular hypotrophy related to varicocele may be reversed by early intervention and they further strengthen the indication for varicocelectomy in children 
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Conclusion With the advantages of less recurrence , easier operating and less time spending , and comparable results in other respects , artery non-preserving is preferable to artery preserving in laparoscopic varicocelectomy , although there is a relatively high incidence of hydrocele formation .