Abstract
Introduction: The aim of this study was to prospectively evaluate changes in patient-reported health-related quality of life after microsurgical subinguinal varicocelectomy using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Methods: This prospective observational study included men presenting with infertility or scrotal symptoms. Fifty patients were initially enrolled, and five with subclinical varicocele were excluded. Forty-five patients with clinically confirmed varicocele underwent microsurgical subinguinal varicocelectomy. Health-related quality of life was assessed preoperatively and at postoperative 3 months using the WHOQOL-BREF instrument. Subgroup analyses were performed according to surgical indication and clinical varicocele grade. Results: The mean WHOQOL-BREF total score significantly improved after surgery (61.4 ± 6.1 preoperatively vs. 70.1 ± 6.9 postoperatively; p = 0.047). Both infertility and pain/swelling groups demonstrated postoperative improvement without a significant difference between indications (p > 0.05). Grade I and II varicocele patients demonstrated significant postoperative improvement. Patients with grade III varicocele also showed postoperative score increases, although statistical significance was not reached within the early follow-up period. Conclusion: Microsurgical subinguinal varicocelectomy provides early improvement in patient-reported quality of life independent of presenting complaint. These findings indicate that the benefits of varicocele repair extend beyond reproductive outcomes and support incorporating patient-reported outcomes into clinical counseling and treatment decision-making.
