To examine the predictive factors of successful redo varicocelectomy in infertile patients with recurrent varicocele, we made a retrospective study. Twenty-one patients who had improved quality of spermatozoon 6 months after RV were designated as group 1, those with no improvement as group 2 (17 subjects) and those who received close surveillance as group 3 (10 patients) were recruited. The predictive factors included were time to recurrent varicocele; semen quality; testicular volume; number of ligated veins; body mass index; serum levels of follicle-stimulating hormone (FSH), luteinising hormone and testosterone; scrotal temperature; and peak retrograde flow (PRF) and maximal vein diameter (MVD) by colour Doppler ultrasound. The quality of spermatozoon improved significantly 6 months after RV in group 1 patients (21, 55.3%), and no improvement in group 2 and 3 patients. Patients in group 1 also had significantly lower FSH and PRF, longer time to recurrent varicocele, higher number of ligated veins and larger testicular volume than the group 2 (17, 44.7%) and group 3 patients. The significant predictive factors of successful RV were lower FSH and PRF; longer time to recurrent varicocele; and larger testicular volume preoperatively and a higher number of ligated veins during redo varicocelectomy.

Information concerning the clinical characteristics in elderly men with varicocoele is relatively limited. This study was assessed to evaluate the differences in clinical characteristics between young and elderly patients with varicocoele by retrospective chart review. Between June 2003 and February 2011, 169 young (18-30 years) men and 156 elderly (45-55 years) men with varicocoele, and 30 age-matched men without varicocoele were recruited for this study. All the patients were divided into six groups. Thirty-one infertile patients were assigned to Group 1, 138 fertile patients to Group 2, 35 infertile patients to Group 3 and 121 fertile patients to Group 4. Group 5 (15 young) and 6 (15 elderly) were control groups. The parameters for comparison included body mass index (BMI), semen quality (sperm motility, morphology and density) and pH value, serum concentration of follicle-stimulating hormone (FSH), luteinizing hormones (LH), testosterone, testicular volume, grade of varicocoele and peak retrograde flow (PRF) and maximal vein diameter (MVD) by colour Doppler ultrasound (CDS). Elderly men with varicocoele had a higher incidence of bilateral varicocoele (25.5% vs. 14.8%), but a lower incidence of unilateral right varicocoele (2.6% vs. 7.7%) than young patients with varicocoele. In addition, patients with varicocoele had lower BMI than those without, and infertile young patients with varicocoele had the lowest levels of BMI. Furthermore, infertile patients (Groups 1 and 3) with varicocoele had significantly lower testicular volume and semen pH, lower levels of testosterone, higher levels of FSH and LH and higher PRF than fertile men with varicocoele (Groups 2 and 4). In conclusion, infertile elderly patients with varicocoele had significantly lower levels of testosterone and higher levels of FSH and LH than infertile young men with varicocoele. In addition, infertile elderly patients with bilateral varicocoele (Group 3, n = 8) had the lowest levels of testosterone.