COMBINED TREATMENT OF PATHOSOSPERMIA WITH ADJUVANT THERAPY WITH SPEROTON COM- PLEX IN PATIENTS WITH VARICOCELE

Abstract

OBJECTIVE To evaluate the effectiveness of combined treatment of pathozoospermia in patients with varicocele by performing micro- surgical phlebectomy of varicose veins of the spermatic cord in combination with adjuvant therapy with the Speroton complex MATERIAL AND METHODS Twenty microsurgical phlebectomies of varicose veins of the spermatic cord were performed in patients with pathozoo- spermia (oligoasthenospermia) against the background of varicocele with the appointment of the Speroton complex in the postoperative period for 3 months with an assessment of spermogram parameters before and after the operation in comparison with a group of 20 men with pathozocelemia without the use of adjuvant therapy. The study of morphological and functional parameters of spermogram of men of reproductive age (18-49 years) without signs of immune infertility (MAR-test IgG <10%) before and after the start of treatment was carried out. The average age of men was 33 ± 2.3 years (M ± m). RESULTS All patients with infertility in combination with varicocele had oligoasthenozoospermia before treatment. Three months after the start of treatment in the study groups, there was a statistically significant improvement in sperm counts due to an increase in the concentration of spermatozoa in 1 ml of ejaculate, an increase in the number of progressively mobile forms and total motility of spermatozoa by 50-68%, an increase in the number of live sperm by 19-20% and a decrease in the num- ber of dead forms of spermatozoa by 30-35%. A statistically significant decrease in the DNA fragmentation index by 34-52% (p <0.05) was found in all study groups. It was found that combination therapy, including microsurgical phlebectomy of the spermatic cord veins using the Speroton complex for 3 months, statistically significantly led to an increase in the concentration of spermatozoa in 1 ml of ejaculate (38.6 [38.2; 69.4]), an increase in progressively mobile forms (49.2 [26.7; 47.2]%) and general motility (72.2 [35.3; 64.7]%) of spermatozoa and viable forms (67.8 [39.3; 81.7] %), a decrease in the DNA fragmenta- tion index compared with the spermogram indicators of patients who underwent only microsurgical phlebectomy (p <0.05 for all study indicators). In the group of patients after combined treatment with the inclusion of adjuvant therapy of the Speroton complex, there was a statistically significant decrease in the sperm DNA fragmentation index to almost normal values (12.1 ± 1.1%) compared with the group of patients who underwent only surgery (17.2 ± 0.8%) (p = 0.01). Combined treatment (micro- surgical phlebectomy of the veins of the spermatic cord in combination with adjuvant therapy Speroton) of pathozoospermia in men of reproductive age with infertility on the background of varicocele can significantly improve the morphofunctional parameters of spermogram after 3 months from the start of treatment compared to men who underwent only surgical correction of varicocele.