Efficacy of varicocelectomy in improving semen parameters in patients with clinical varicocele

Abstract

Despite various studies published in the recent years, efficacy of varicocelectomy and its influence on semen parameters, particularly sperm count, motility and morphology has not yet been determined. Conflicting results obtained in different studies, accounts for sparked interest in varicocele management and its effects on seminal parameters. Therefore, present study was designed in an attempt to evaluate the effect of varicocelectomy on the semen parameters by analyzing reports that included men with varicoceles who had both preoperative and postoperative semen examination done. To determine the efficacy of varicocelectomy in improving semen parameters semen parameters (count, motility and morphology) by analyzing reports that included men with varicoceles who had both preoperative and postoperative Spermatogram. The present retrospective study enrolled 50 patients in Tripoli University Hospital medical center, Tripoli /Libya. Varicocele was graded by Dubin grading system by palpation in standing and during Valsalva maneuver under adequate exposure and scrotal Doppler ultrasound Macro and microscopic assessment of semen samples was carried out according to WHO guidelines 2010. The surgical approach used for varicocelectomy was inguinal (low ligation procedure), post operative semen analysis done after 6 months from surgery. Significant improvement in semen parameters (viz sperm counts/ml, sperm counts/ejaculate and sperm motility) were observed after varicocelectomy. We noted no effect of patient’s age on the degree of improvement in semen parameters post operatively. Preoperatively, men with Grade IV varicoceles had lower sperm counts and sperm motility, but significant improvement was observed post-operatively compared to men with Grades II and III varicoceles