Effect of Varicocelectomy on Semen Parameters of Men Seeking Infertility Treatment in Tamale, Ghana

Adams, Yussif; Afoko, A.A.; Amidu, Nafiu

doi:10.4236/oju.2022.121002

Cited by 2 publications

(4 citation statements)

References 35 publications

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“…11,24,38 The post-surgery complications are discussed elsewhere. 12 The hypothesis of improvement in vascular supply is limited to mean values and could be a limitation. Omission of resistive index measurement for centripetal arteries, determination of pulsatility index (PI), as well as absence of genetic testing are some of the limitations of this study.…”

Section: Discussionmentioning

confidence: 99%

“…normal ovulation, normal reproductive history, and tubal patency). 15 However, patients with a history of undescended testis, orchidectomy, mumps orchitis, uncontrolled diabetes (glycated hemoglobin of >7%), and uncontrolled hypertension (blood pressure of ⩾140/90 mmHg) as discussed elsewhere 12 were excluded from the study.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…The wound was closed in layers and a subcuticular skin stitch was applied using 4/0 PGA sutures as described elsewhere. 12 Left sided varicocelectomy was performed for participants with left side varicocele and bilateral varicocelectomy was performed for participants with bilateral varicocele. There was no isolated right-side varicocele among the surgery group.…”

Section: Microsurgical Sub-inguinal Varicocelectomy For the Surgery G...mentioning

confidence: 99%

“…The microsurgical repair approach has become popular among other varicocele treatment methods because it is associated with improved Leydig cell function 2,12,13 and reduced complications and/or recurrence of varicocele. 14 The two approaches are microsurgical sub-inguinal and inguinal varicocelectomy but vascular anatomy gets more complicated as we get through the sub-inguinal region to the inguinal region, thus leaving the microsurgical sub-inguinal (lymphatic- and artery sparing) varicocelectomy the most appropriate choice.…”

Section: Introductionmentioning

confidence: 99%

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Changes in testicular arterial hemodynamic, gonadotropin levels, and semen parameters among varicocele patients randomized to varicocelectomy or observed in Tamale, Ghana

2022

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Objective: A randomized trial to compared testicular blood flow parameters, gonadal hormones, and semen characteristics among three groups; surgery group ( n = 127); observed group ( n = 114); and healthy controls ( n = 33). Methods: The blood flow parameter selected was resistive index (RI) measured using color Doppler ultrasonography. Serum total testosterone, FSH, LH were measured, and semen analysis performed at baseline and repeated 12 months of follow-up. The data was computed using GraphPad Prism (v8.0) at an alpha of 0.05. Results: In the observed group, increased +0.0060 in the right (R_RI) and in the left (L_RI) +0.0026 capsular arteries from baseline measurement to 12 months follow-up. Surgery group, reduced –0.079 in the right (R_RI) and −0.0731 in the left (L_RI) capsular arteries ( p < 0.0001). At 12 months, the changes for both left and right RIcap in the surgery group did not reach the values of the controls. In the surgery group, L_RIcap ( r = −0.63; p < 0.0001) and R_RIcap ( r = −0.49; p = 0.004) correlated with total testosterone, FSH ( r = 0.57; p = 0.001 for left; r = 0.52; p = 0.002 for right), and LH ( r = 0.61; p = 0.0002 for left; r = 0.41; p = 0.020 for right). Furthermore, L_RIcap correlated with changes in sperm count ( r = −0.46; p = 0.008) and sperm concentration ( r = −0.35; p = 0.011) in the surgery group. Conclusion: Microsurgical sub-inguinal varicocelectomy improves blood supply to the testicular tissues evidenced by reduced resistive index in the surgery group. Resistive index in the left capsular artery can be used to evaluate the success of surgery because it correlates with total testosterone, FSH, LH, and semen quality.

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