Does the number of veins ligated during varicococele surgery influence post-operative semen and hormone results?

Abstract

SUMMARYVaricocele is a well-established cause of male subfertility, which is directly proportional to its clinical grade. Although newer ultrasonic grading systems have taken into account the existence of pampiniform venous plexi, little is known about the clinical significance of the number of veins ligated during surgery. Very few undersized studies reported an influence which triggered the need to evaluate such association. This is a retrospective study of 378 patients who underwent left microsurgical subinguinal varicocoelectomy. Semen analyses and blood hormone studies performed pre-operatively were compared to those executed 6 months after surgery. Patients were divided into abnormal semen and normal semen groups based on their initial semen results. They were also subdivided according to the number of veins ligated intraoperatively into three groups: <5, 5-10, and >10 veins. Sperm count, total motility, and progressive motility were significantly increased in 62, 60.3, and 53.3% of patients post-operatively (p = 0.001), respectively. No significant differences in hormone levels were detected overall. Of the 378 patients, 332 had an abnormal semen analysis, while the remaining 46 patients had a normal result. Sperm count, total motility, and progressive motility significantly increased after varicocoelectomy in patients with an abnormal initial semen analysis (p = 0.001). In 48.7% of patients, 5-10 veins were ligated during surgery, whereas 28.3% had >10 and 23% had <5 ligated veins. No statistically significant differences were noted in the initial or the follow-up results among the number of vein subgroups. Varicocele ligation improves patients' fertility potential. This improvement, however, is not influenced by the number of veins ligated intraoperatively. Clinical grading maintains its superiority in the evaluation of varicocele patients.

Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility

“…In a cross sectional study of 1,162 patients, Majzoub et al [ 82 ] observed a positive correlation between the percentage of abnormal sperm heads and levels of ORP (p<0.001) and SDF (p<0.001). This confirms that OS is highly implicated in sperm DNA damage, especially SDF [ 83 84 85 ].…”

Impact of body mass index on semen parameters and reproductive hormones among men undergoing microsurgical subinguinal varicocelectomy

“…Varicocelectomy was performed using the microsurgical subinguinal approach. All cases were done by the same urology team using a standardized approach [ 25 ]. Procedures were done under general anesthesia, utilizing a 2–3 cm subinguinal incision.…”

Does varicocelectomy improve semen in men with azoospermia and clinically palpable varicocele?

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