Varicocelectomy

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Armand Zini - One of the best experts on this subject based on the ideXlab platform.

  • is Varicocelectomy beneficial in men previously deemed subfertile but with normal semen parameters based on the new guidelines a retrospective study
    Urology, 2014
    Co-Authors: Patrick Mcgarry, Keith Jarvi, Khalid Alrabeeah, Armand Zini
    Abstract:

    Objective To determine whether using the 2010 World Health Organization (WHO) semen parameter reference values to select Varicocelectomy candidates may exclude infertile men who can potentially benefit from this treatment. With the application of the 2010 WHO semen parameter thresholds, some men previously considered to have abnormal semen parameters would now be considered normozoospermic. Methods We conducted a retrospective review of infertile men with varicocele and identified those with abnormal semen parameters according to WHO 1992 or 1999 standards but normozoospermic by WHO 2010 standards. We compared outcomes (semen parameters and spontaneous pregnancy) of couples undergoing Varicocelectomy with those choosing observation. Results We identified 445 infertile men with varicocele and abnormal semen parameters by WHO 1992 or 1999 standards. Fifty-six of 445 men (13%) were normozoospermic by WHO 2010. Thirty-two of 56 (57%) of these normozoospermic men elected to have Varicocelectomy, and 24 of 56 men (43%) choosing observation. In these normozoospermic men (by WHO 2010), Varicocelectomy was associated with a significant increase in sperm concentration (50 ± 35 × 10 6 /mL [postsurgery] vs 32 ± 23 × 10 6 /mL [presurgery]; P  = .003). Although not statistically significant, the clinical pregnancy rate was higher in the Varicocelectomy group compared with the observation group (52% vs 38%; P  = .37). Conclusion Varicocelectomy may be beneficial in those men with clinical varicocele and abnormal semen parameters by WHO 1992 or 1999 standards but now normozoospermic by WHO 2010 standards. Applying the 2010 WHO semen parameter reference values into practice may result in missed opportunities to correct treatable causes of male infertility.

  • effect of microsurgical Varicocelectomy on human sperm chromatin and dna integrity a prospective trial
    International Journal of Andrology, 2011
    Co-Authors: Armand Zini, Abdulaziz Baazeem, R Azhar, Maria San Gabriel
    Abstract:

    Summary There is evidence from retrospective studies that Varicocelectomy can improve sperm DNA damage in infertile men with a clinical varicocele. The objective of this prospective study was to examine further the effect of Varicocelectomy on sperm chromatin and DNA integrity. We evaluated a consecutive series of infertile men (n = 25) who underwent microsurgical Varicocelectomy for treatment of clinical varicocele. We examined conventional sperm parameters and sperm chromatin structure assay parameters (percentage DFI – DNA fragmentation index and percentage HDS – high DNA stainability, an index of chromatin compaction) before and 4 and 6 months after microsurgical Varicocelectomy. Sperm DNA integrity improved significantly after surgery (percentage DFI decreased from 18 ± 11% before surgery to 10 ± 5%, and 7 ± 3%, at 4 and 6 months after surgery respectively). Sperm chromatin compaction also improved significantly after surgery (percentage HDS decreased from 11 ± 7% before surgery to 8 ± 6%, and 7 ± 5%, at 4 and 6 months after surgery, respectively). Sperm concentration and progressive motility improved after surgery, although the differences were not statistically significant when compared with that before surgery. The data show that Varicocelectomy is associated with an improvement in sperm DNA integrity and chromatin compaction. These findings support the concept that correction of a varicocele can improve spermatogenesis, particularly spermiogenesis (the stage in spermatogenesis where compaction and stability of the sperm DNA and chromatin occur).

  • microanatomy of the left and right spermatic cords at subinguinal microsurgical Varicocelectomy comparative study of primary and redo repairs
    Urology, 2010
    Co-Authors: Jamie Libman, Robert Segal, Abdulaziz Baazeem, Jason Boman, Armand Zini
    Abstract:

    Objectives To examine and compare the left and right spermatic cord arterial and lymphatic anatomy identified at primary and redo microsurgical subinguinal Varicocelectomy. Methods We reviewed the operative reports of 335 consecutive microsurgical varicocelectomies performed by a single surgeon: 325 primary repairs and 10 reoperations. We recorded number of testicular arteries (internal and external spermatic) and lymphatic channels preserved at subinguinal microsurgical Varicocelectomy, and evaluated the relationship between the right and left vascular anatomy at bilateral Varicocelectomy. Results A total of 235 left-sided and 90 bilateral primary repairs were performed. A mean (± standard deviation) number of 2.4 ± 1.0 arteries and 4.6 ± 1.5 lymphatics were identified during the left-sided repairs. For bilateral repairs, there were 2.4 ± 0.9 arteries and 4.4 ± 1.2 lymphatics on the left and 2.2 ± 0.9 arteries and 4.2 ± 1.3 lymphatics on the right with a significant correlation between the number of right and left internal spermatic arteries (r = 0.42). For the cohort of secondary (redo) varicocelectomies, we identified 2.3 ± 0.6 arteries and 4.8 ± 1.6 lymphatic channels (not significantly different from the primary Varicocelectomy cohorts). Conclusions The number of arteries and lymphatics preserved at microsurgical Varicocelectomy is highly variable, but there is some similarity in the microanatomy of the right and left spermatic cords at the level of the external inguinal ring. The data also suggest that the number of arteries and lymphatic channels identified at a redo Varicocelectomy is comparable to that observed during a primary Varicocelectomy.

  • microsurgical Varicocelectomy for infertile men with oligospermia differential effect of bilateral and unilateral varicocele on pregnancy outcomes
    BJUI, 2009
    Co-Authors: Abdulaziz Baazeem, Keith Jarvi, Jamie Libman, Jason Boman, Armand Zini
    Abstract:

    OBJECTIVES To evaluate the pregnancy outcomes of two groups of oligospermic men with varicocele, one having a Varicocelectomy (group 1) and the other electing not to have surgery (group 2), as varicocele represents the most common factor associated with male infertility and most reports indicate that Varicocelectomy has a beneficial effect on male fertility and pregnancy outcome. PATIENTS AND METHODS We retrospectively reviewed consecutive oligospermic men who had microsurgical Varicocelectomy (233, group 1) between September 1996 and January 2002 and a consecutive group of oligospermic men with varicoceles who elected not to have surgery (127, group 2). The outcome measures included changes in semen variables, partner pregnancy rates (assisted and unassisted) and use of assisted reproductive technologies (ART). RESULTS The mean sperm concentration and motility increased significantly after Varicocelectomy (P < 0.05). The natural pregnancy rate in group 1 (38%) was higher than in group 2 (30%). The use of ART was significantly greater in group 2 than group 1. In the subset of couples with bilateral varicocele, the natural pregnancy rate was significantly higher in group 1 than group 2 (48% vs 15%, respectively, P = 0.008). CONCLUSIONS This study suggests that the natural pregnancy rate is higher after Varicocelectomy than in those not having surgery, although the difference was not statistically significant. However, in the subset of couples with bilateral varicocele, the spontaneous pregnancy rates were significantly higher after surgery.

  • microsurgical Varicocelectomy for isolated asthenospermia
    The Journal of Urology, 2008
    Co-Authors: Jason Boman, Jamie Libman, Armand Zini
    Abstract:

    Purpose: Varicocele represents the most common cause of male infertility, and most reports indicate that Varicocelectomy has a beneficial effect on male fertility and pregnancy outcome. We evaluated the clinical outcomes of infertile couples with varicocele and isolated asthenospermia who chose to undergo Varicocelectomy as well as those who chose not to undergo the procedure.Materials and Methods: We performed a retrospective review of 118 consecutive infertile couples in whom the man presented with clinical varicocele and isolated asthenospermia (less than 50% motile sperm). All couples were presented with possible treatment options (observation, Varicocelectomy, assisted reproductive technologies). The clinical characteristics and outcomes of 2 subgroups of men—those who elected to undergo surgery (Varicocelectomy, 69) and those who did not (49)—were examined and compared.Results: Mean male and female patient age, duration of infertility and baseline total motile sperm count were not significantly diff...

Marc Goldstein - One of the best experts on this subject based on the ideXlab platform.

  • microsurgical Varicocelectomy a review
    Asian Journal of Andrology, 2013
    Co-Authors: Akanksha Mehta, Marc Goldstein
    Abstract:

    Varicocelectomy is the most commonly performed surgical procedure for the treatment of male infertility. Although several different techniques for varicocele repair have been described in the literature, microsurgical Varicocelectomy performed through a subinguinal or inguinal incision is recognized as the gold-standard approach for Varicocelectomy, due to high success rates with minimal complications. Standard indications for Varicocelectomy include palpable varicocele(s), with one or more abnormal semen parameters, and, for the couple trying to conceive, in the setting of normal or correctable female infertility. However, varicocele repair is often recommended and undertaken for reasons other than infertility, including low serum testosterone, testicular pain, testicular hypotrophy and poor sperm DNA quality. This article reviews the technical aspects of microsurgical Varicocelectomy, and its indications in adults and adolescents.

  • 2280 Varicocelectomy is associated with increases in serum testosterone regardless of clinical grade
    The Journal of Urology, 2011
    Co-Authors: Wayland Hsiao, James S Rosoff, Joseph R Pale, Jonathan Powell, Marc Goldstein
    Abstract:

    Objective To determine whether the varicocele grade is related to the degree of improvement in serum testosterone levels after Varicocelectomy. Materials and Methods We performed a retrospective review of men with a total serum testosterone level  P  ≤.05 was considered statistically significant. Results A total of 59 patients had undergone bilateral Varicocelectomy and 19 unilateral Varicocelectomy. Overall, an increase in testosterone was seen in 65 of the 78 men (83%) in the present study. The mean follow-up was 7 months. The mean serum testosterone level increased from 308.4 to 417.5 ng/dL, with a mean increase of 109.1 ± 12.8 ng/dL (n = 78). The improvements in the serum testosterone levels were seen regardless of the clinical grade. Conclusion Microsurgical Varicocelectomy resulted in significant increases in the serum testosterone level, independent of the varicocele grade.

  • older age is associated with similar improvements in semen parameters and testosterone after subinguinal microsurgical Varicocelectomy
    The Journal of Urology, 2011
    Co-Authors: Marc Goldstein, Wayland Hsiao, James S Rosoff, Joseph R Pale, Eleni A Greenwood
    Abstract:

    Purpose: It is generally accepted that men with clinically palpable varicocele are at high risk for a progressive decrease in fertility and testosterone levels with time. Varicocelectomy is thought to improve testicular function or at least halt the accelerated decrease in testicular function associated with varicocele. Substantial controversy exists as to whether Varicocelectomy is effective in older men, possibly due to irreversible testicular damage or limited potential for recovery from varicocele induced damage.Materials and Methods: We retrospectively reviewed the records of men who underwent microsurgical subinguinal Varicocelectomy, as done by a single surgeon. Demographics, patient questionnaires, operative notes, charts, testosterone and semen analysis were reviewed. Patients were divided into 3 groups based on age at surgery, including less than 30, 30 to 39 and 40 years or greater.Results: A total of 272 men met study inclusion criteria. In all 3 age groups we noted similar testosterone and ba...

  • Simultaneous Vasectomy and Varicocelectomy: Indications and Technique
    Urology, 2007
    Co-Authors: Philip S. Li, Marc Goldstein
    Abstract:

    Introduction When men present for vasectomy, incidental varicoceles may be discovered. After Varicocelectomy, the deferential veins become the only avenue for testicular venous return and could be compromised during nonmicroscopic vasectomy. We discuss the indications and technique required to safely perform simultaneous vasectomy and Varicocelectomy. Technical Considerations From 1992 to 2005, 18 (4.8%) of 379 men presenting for vasectomy had incidental palpable varicoceles and low or low normal serum testosterone levels. All underwent microsurgical subinguinal Varicocelectomy. All spermatic, cremasteric, and gubernacular veins were ligated. The vas was then isolated under magnification, the deferential vessels were preserved, and the vas was transected, cauterized, and clipped. Results All 18 men (mean age 39.6 years) had grade II to III varicoceles on physical examination. We performed 27 microsurgical varicocelectomies with simultaneous microsurgical vasectomy. On average, the first follow-up visit occurred 14 weeks postoperatively. The mean testosterone level increased from 348 ng/dL preoperatively to 416 ng/dL postoperatively. No complications, episodes of testicular atrophy, vasectomy failures, or Varicocelectomy recurrences developed. The incidence of varicoceles in fertile men presenting for vasectomy (4.8%) was lower than in the general population (15%); fertile men appear to be less likely to possess varicoceles. Conclusions Men presenting for vasectomy with incidental palpable varicoceles could benefit from simultaneous vasectomy-Varicocelectomy. This should be performed microsurgically to identify and ligate both spermatic veins and vasa deferentia and to preserve not only the testicular artery, but also the deferential vessels to minimize the risk of testicular atrophy and the risk of insufficient venous drainage.

  • managing varicoceles in children results with microsurgical Varicocelectomy
    BJUI, 2005
    Co-Authors: Jonathan D Schiff, Marc Goldstein, Cathy Kelly, Peter Schelgel, Dix P Poppas
    Abstract:

    Authors from New York present their experience of elective Varicocelectomy, using microsurgical techniques, in a large series of children. They found the procedure to be safe and effective, and gave a much lower complication rate than the published rate in open Varicocelectomy. The results of urethroplasty in post-traumatic paediatric urethral strictures are presented by authors from Mansoura. They found the overall success of one-stage perineal anastomotic repair of such strictures to be excellent, with very little morbidity. OBJECTIVE To report our experience of microsurgical subinguinal Varicocelectomy in boys aged ≤ 18 years. PATIENTS AND METHODS Boys aged ≤ 18 years treated with microsurgical Varicocelectomy between 1996 and 2000 at one institution were retrospectively reviewed. Indications for surgery included ipsilateral testicular atrophy, large varicocele or pain. Microsurgery was assisted by an operating microscope (×10–25) allowing preservation of the lymphatics, and the testicular and cremasteric arteries. Patient age, varicocele grade, complications and follow-up interval were recorded. RESULTS In all there were 97 microsurgical subinguinal varicocelectomies (23 bilateral) in 74 boys (mean age 14.7 years). Left-sided varicoceles were significantly larger (mean grade 2.9) than right-sided (mean grade 1.4) varicoceles. The mean follow-up was 9.6 months. There were four complications: two hydroceles, of which one resolved spontaneously after 4 months; one patient had persistent orchialgia that resolved after 8 months; and one developed hypertrophic scarring at the inguinal incision site. There were no infections, haematomas or intraoperative injuries to the vas deferens or testicular arteries. All boys were discharged home on the day of surgery. CONCLUSIONS Microsurgical subinguinal Varicocelectomy in boys is a safe, minimally invasive and effective means of treating varicoceles. Compared with published results of the retroperitoneal mass ligation technique, which has a 15% overall complication rate and a 7–9% hydrocele occurrence rate, the microsurgical subinguinal approach appears to offer less morbidity, with a 1% hydrocele rate. We consider that microsurgical subinguinal Varicocelectomy offers the best results with lower morbidity than other techniques.

Keith Jarvi - One of the best experts on this subject based on the ideXlab platform.

  • is Varicocelectomy beneficial in men previously deemed subfertile but with normal semen parameters based on the new guidelines a retrospective study
    Urology, 2014
    Co-Authors: Patrick Mcgarry, Keith Jarvi, Khalid Alrabeeah, Armand Zini
    Abstract:

    Objective To determine whether using the 2010 World Health Organization (WHO) semen parameter reference values to select Varicocelectomy candidates may exclude infertile men who can potentially benefit from this treatment. With the application of the 2010 WHO semen parameter thresholds, some men previously considered to have abnormal semen parameters would now be considered normozoospermic. Methods We conducted a retrospective review of infertile men with varicocele and identified those with abnormal semen parameters according to WHO 1992 or 1999 standards but normozoospermic by WHO 2010 standards. We compared outcomes (semen parameters and spontaneous pregnancy) of couples undergoing Varicocelectomy with those choosing observation. Results We identified 445 infertile men with varicocele and abnormal semen parameters by WHO 1992 or 1999 standards. Fifty-six of 445 men (13%) were normozoospermic by WHO 2010. Thirty-two of 56 (57%) of these normozoospermic men elected to have Varicocelectomy, and 24 of 56 men (43%) choosing observation. In these normozoospermic men (by WHO 2010), Varicocelectomy was associated with a significant increase in sperm concentration (50 ± 35 × 10 6 /mL [postsurgery] vs 32 ± 23 × 10 6 /mL [presurgery]; P  = .003). Although not statistically significant, the clinical pregnancy rate was higher in the Varicocelectomy group compared with the observation group (52% vs 38%; P  = .37). Conclusion Varicocelectomy may be beneficial in those men with clinical varicocele and abnormal semen parameters by WHO 1992 or 1999 standards but now normozoospermic by WHO 2010 standards. Applying the 2010 WHO semen parameter reference values into practice may result in missed opportunities to correct treatable causes of male infertility.

  • Time for improvement in semen parameters after Varicocelectomy
    Journal of Urology, 2012
    Co-Authors: Ali El Bakri, Kirk Lo, Ethan Grober, Joao Paulo Cardoso, Dorris Cassidy, Keith Jarvi
    Abstract:

    Purpose: While there are a number of studies documenting a positive effect of Varicocelectomy on semen parameters, the length of time required following Varicocelectomy for semen quality to improve is not well established. Therefore, in this study we identified the changes with time in semen parameters after Varicocelectomy. Materials and Methods: The records and database of 304 patients who underwent varicocele repair for subfertility were reviewed retrospectively. All men had at least 2 preoperative semen analyses as well as semen testing at 3 and 6 months postoperatively. Results: For the 100 patients who met the study inclusion criteria mean sperm counts increased significantly by 3 and 6 months after Varicocelectomy (by 53% and 38% by 3 and 6 months, p = 0.0003 and 0.001, respectively). By 3 and 6 months the combined groups had a mean 2.5 and 1.5-fold higher total motile count compared to the preoperative total motile count, respectively. There was no further improvement in semen parameters in those men followed for more than 6 months. There were no statistically significant differences in the improvement in semen volume, motility, count or total motile count comparing the results at 3, 6 and more than 9 months postoperatively. Conclusions: Sperm parameters improve by 3 months after varicocele repair and then do not improve further. This finding should allow physicians to decide quickly if Varicocelectomy has been effective and, then, if required, plan on the use of other therapies to manage the couples' infertility. © 2012 American Urological Association Education and Research, Inc.

  • time for improvement in semen parameters after Varicocelectomy
    The Journal of Urology, 2012
    Co-Authors: Ali El Bakri, Joao Paulo Cardoso, Ethan D Grober, Kirk C. Lo, Darby Cassidy, Keith Jarvi
    Abstract:

    Purpose: While there are a number of studies documenting a positive effect of Varicocelectomy on semen parameters, the length of time required following Varicocelectomy for semen quality to improve is not well established. Therefore, in this study we identified the changes with time in semen parameters after Varicocelectomy.Materials and Methods: The records and database of 304 patients who underwent varicocele repair for subfertility were reviewed retrospectively. All men had at least 2 preoperative semen analyses as well as semen testing at 3 and 6 months postoperatively.Results: For the 100 patients who met the study inclusion criteria mean sperm counts increased significantly by 3 and 6 months after Varicocelectomy (by 53% and 38% by 3 and 6 months, p = 0.0003 and 0.001, respectively). By 3 and 6 months the combined groups had a mean 2.5 and 1.5-fold higher total motile count compared to the preoperative total motile count, respectively. There was no further improvement in semen parameters in those me...

  • microsurgical Varicocelectomy for infertile men with oligospermia differential effect of bilateral and unilateral varicocele on pregnancy outcomes
    BJUI, 2009
    Co-Authors: Abdulaziz Baazeem, Keith Jarvi, Jamie Libman, Jason Boman, Armand Zini
    Abstract:

    OBJECTIVES To evaluate the pregnancy outcomes of two groups of oligospermic men with varicocele, one having a Varicocelectomy (group 1) and the other electing not to have surgery (group 2), as varicocele represents the most common factor associated with male infertility and most reports indicate that Varicocelectomy has a beneficial effect on male fertility and pregnancy outcome. PATIENTS AND METHODS We retrospectively reviewed consecutive oligospermic men who had microsurgical Varicocelectomy (233, group 1) between September 1996 and January 2002 and a consecutive group of oligospermic men with varicoceles who elected not to have surgery (127, group 2). The outcome measures included changes in semen variables, partner pregnancy rates (assisted and unassisted) and use of assisted reproductive technologies (ART). RESULTS The mean sperm concentration and motility increased significantly after Varicocelectomy (P < 0.05). The natural pregnancy rate in group 1 (38%) was higher than in group 2 (30%). The use of ART was significantly greater in group 2 than group 1. In the subset of couples with bilateral varicocele, the natural pregnancy rate was significantly higher in group 1 than group 2 (48% vs 15%, respectively, P = 0.008). CONCLUSIONS This study suggests that the natural pregnancy rate is higher after Varicocelectomy than in those not having surgery, although the difference was not statistically significant. However, in the subset of couples with bilateral varicocele, the spontaneous pregnancy rates were significantly higher after surgery.

  • Varicocelectomy for infertile couples with advanced paternal age
    Urology, 2008
    Co-Authors: Armand Zini, Keith Jarvi, Jason Boman, Abdulaziz Baazeem
    Abstract:

    We identified 115 men aged 40 years and older and 466 men younger than 40 years with a clinical varicocele and infertility. The proportion of men with secondary infertility was significantly higher in the group of men aged 40 years and older compared with the men younger than 40 years (43% [50 of 115] versus 19% [87 of 466], respectively;P!0.001). There were no significant differences in baseline sperm parameters and in spontaneous pregnancy rates after Varicocelectomy in couples with advanced paternal age (40 years or older) compared with the younger couples (49% versus 39%, respectively). However, the spontaneous pregnancy rate in couples with advanced paternal age (40 years or older) who underwent Varicocelectomy was significantly greater than that of the age-matched control group who did not undergo surgery (49% versus 21%, respectively;P!0.05). CONCLUSIONSThe results of this study suggest that paternal age does not adversely influence pregnancy outcome after Varicocelectomy. The data support the practice of Varicocelectomy for treatment of clinical varicocele and infertility in older men.UROLOGY72: 109‐113, 2008. © 2008 Elsevier Inc.

Peter N Schlegel - One of the best experts on this subject based on the ideXlab platform.

  • microsurgical inguinal Varicocelectomy with and without testicular delivery
    Urology, 2006
    Co-Authors: Ranjith Ramasamy, Peter N Schlegel
    Abstract:

    Abstract Objectives To evaluate the effect of the delivery of testis on semen parameters, serum testosterone, and pregnancy rates after Varicocelectomy, performed with and without delivery of the testis. Methods A total of 165 patients with clinically diagnosed varicoceles who underwent surgical ligation with (n = 55) or without (n = 110) testicular delivery were included in this study. Patients were followed up postoperatively at 3, 6, and 9 to 24 months. The postoperative outcome was assessed by determination of the semen parameters, testosterone level, varicocele recurrence, and pregnancy rate. Results No varicocele recurrences were clinically detectable after either surgical approach. The mean increase in motile sperm/ejaculate after Varicocelectomy without testicular delivery was significant ( P P Conclusions The results of our study have shown that Varicocelectomy without testicular delivery has equivalent or more beneficial effects on semen parameters without affecting varicocele recurrence rates. Delivery of the testis did not offer any beneficial effects on semen quality or pregnancy rates after Varicocelectomy.

  • role of Varicocelectomy in men with nonobstructive azoospermia
    Fertility and Sterility, 2004
    Co-Authors: Peter N Schlegel, Jeremy Kaufmann
    Abstract:

    Abstract Objective To evaluate the benefits of Varicocelectomy in men with nonobstructive azoospermia. Design Retrospective review of effect of prior Varicocelectomy on sperm retrieval rates in men with nonobstructive azoospermia. Chart review of men with nonobstructive azoospermia who underwent microsurgical Varicocelectomy to determine the effect of the procedure on the need for testicular sperm extraction (TESE). Setting Tertiary, university-based referral center. Patient(s) Men with clinical varicoceles and nonobstructive azoospermia. Intervention(s) Microsurgical Varicocelectomy, TESE. Main outcome measure(s) Return of sperm to the ejaculate and need for TESE after varicocele repair, ability to find sperm using microdissection TESE. Result(s) Of 31 men who underwent varicocele repair at one institution for documented nonobstructive azoospermia, 7/31 (22%) had sperm reported on at least one semen analysis postoperatively. However, only 3/31 (9.6%) men after varicocele repair had adequate motile sperm in the ejaculate for ICSI, without TESE. Sperm retrieval rates for men with varicoceles were not affected by a history of prior Varicocelectomy. Conclusion(s) Men with clinical varicoceles that are associated with nonobstructive azoospermia will rarely have adequate sperm in the ejaculate after varicocele repair to avoid TESE. A history of prior varicocele repair does not appear to affect the chance of sperm retrieval by TESE for men with clinical varicoceles and nonobstructive azoospermia. The benefits of Varicocelectomy in men with nonobstructive azoospermia may be less than previously reported.

  • the effect of Varicocelectomy on serum testosterone levels in infertile men with varicoceles
    The Journal of Urology, 1995
    Co-Authors: Liming Su, Marc Goldstein, Peter N Schlegel
    Abstract:

    AbstractPurpose: We evaluated the effect of Varicocelectomy on serum testosterone.Materials and Methods: We retrospectively reviewed the effect of Varicocelectomy on serum testosterone levels in 53 infertile men with varicoceles.Results: Mean serum testosterone increased from a preoperative level of 319 plus/minus 12 to 409 plus/minus 23 ng./dl. postoperatively (p less than 0.0004). Men with at least 1 firm testis preoperatively had a greater increase in serum testosterone (p less than 0.005). An inverse correlation was noted between preoperative testosterone levels and change in testosterone after Varicocelectomy (r = −0.34, p less than 0.013).Conclusions: Varicocelectomy can increase serum testosterone for infertile men with varicoceles. Although improvement in serum testosterone does not necessarily cause a direct improvement in semen quality, Varicocelectomy may improve hormonal and spermatogenic function.

Wayland Hsiao - One of the best experts on this subject based on the ideXlab platform.

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