Efficacy of Varicocele Repair in Different Age Groups

Yazdani, Mehrdad; Hadi, Mazaher; Abbasi, Homayoun; Nouri-Mahdavi, Kia; Khalighinejad, Pooyan; Mirsattari, Arash; Hadi, Ali A.

doi:10.1016/j.urology.2015.05.004

Cited by 11 publications

(3 citation statements)

References 14 publications

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“…Similarly, Yazdani and colleagues reported statistically significant SC improvement after varicocelectomy in older patients, in this case, older than 30 years (p < 0.001). 17 In addition, Ishikawa and colleagues found improvement of semen characteristics after varicocele repair in patients aged 20-29 years, and those over 30 years, concluding that it is reasonable to perform ligation to improve the semen characteristics in patients older than 40 years old. 18 In addition, Cox regression analysis performed by Zhang and colleagues in a prospective cohort study of 120 males with varicocele who underwent MSV showed no role of age as a predictor of spontaneous pregnancy rate improvement.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors affecting semen improvement after microsurgical subinguinal varicocelectomy: Which subfertile patients benefit from surgery?

Palmisano¹,

Moreno-Mendoza²,

Ievoli³

et al. 2019

European Urology Supplements

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Background: The exact mechanism of varicocele-related infertility is still elusive, therefore, the current challenges for its management lie in determining which patients stand to benefit most from surgical correction. The authors aimed to assess the clinical factors affecting semen improvement after left microsurgical subinguinal varicocelectomy (MSV) in relation to patient age, ultrasound varicocele grading (USVG), and presence of a right subclinical varicocele (RSV). Methods: From 2010 to 2017 a total of 228 infertile patients underwent left MSV for clinical varicocele. Descriptive statistics were used to describe the cohort and verify the surgical benefit in terms of semen improvement, in addition, subsets of patients were selected according to clinical covariates. Logistic regression modeling was applied to evaluate the presence of RSV, operative time, age, and USVG as explanatory variables. Results: Sperm concentration (SC), progressive sperm motility (PSM), and normal sperm morphology (NSM) increased significantly after surgery (p = 0.002; p = 0.011; p = 0.024; respectively). Mean SC improved after MSV in ⩾35 year-old patients and the grade 3 USVG group (p = 0.01; p = 0.02; respectively). Logistic regression modeling showed a that the probability of SC improvement was 76% lower in subjects presenting RSV (p = 0.011). In addition, patients with a grade 3 USVG presented a three-times greater probability of SC improvement compared with patients with a lower USVG (p = 0.035). In addition, older patients showed a greater probability of SC improvement after MSV (p = 0.041). Conclusions: MSV is an effective varicocele-related infertility treatment that should also be offered to older patients. In addition, patients with a higher USVG benefit from surgery. In infertile men with an RSV in association with a left clinical disease, a bilateral varicocele repair should be considered.

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Section: Discussionmentioning

confidence: 99%

Clinical factors affecting semen improvement after microsurgical subinguinal varicocelectomy: Which subfertile patients benefit from surgery?

Palmisano¹,

Moreno-Mendoza²,

Ievoli³

et al. 2019

European Urology Supplements

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“…Yazdani M et al, studied efficacy of varicocele repair in different age groups. 25 They divided 83 patients into two groups of less than 30 years and more than 30 years. They found semen parameters improved in both groups and there was no statistically significant difference between two groups regarding efficacy of varicocelectomy.…”

Section: Discussionmentioning

confidence: 99%

Benefit of varicocelectomy in infertile men with varicocele

Awati

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Varicocelectomy does improve semen parameters and pregnancy rates in men with infertility. Various studies have shown the extent of benefit and also shown that some may not benefit. It is important to counsel the patients about the same. The present study was done to determine how much varicocelectomy is beneficial to infertile men with varicocele.Methods: A prospective observational cohort study was conducted on 25 patients undergoing varicocelectomy for infertility at St. John Medical College Hospital, Bangalore from 1st June 2013 to 31st May 2014. Clinical data, semen analysis, scrotal imaging was done and postoperatively semen analysis was done after three months. The data was analysed to find out how much was the benefit of varicocelectomy.Results: Twenty-five patients underwent varicocelectomy, all of them showed improvement of semen parameters. Fifteen of them had more than 50% of improvement. This showed that varicocelectomy is beneficial to about 60% of patients.Conclusions: Varicocelectomy is beneficial to infertile men with palpable varicocele and abnormal semen parameters.

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“…4 Despite the wealth of evidence demonstrating the clinical benefit of varicocele repair, most studies follow patients at 3-month intervals for a maximum of 6-12 months. 8,9 Scant literature exists to qualify durability of such improvement at periods ≥12 months. The aim of this study is to analyze the durability of improvements in post-operative semen parameters following microsurgical varicocele repair.…”

Section: Introductionmentioning

confidence: 99%

Semen parameter improvements after microsurgical subinguinal varicocele repair are durable for more than 12 months

Madhusoodanan

Patel

Blachman‐Braun

2019

CUAJ

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Introduction: Varicoceles account for the most common correctable cause of male infertility, with varicocele repair leading to improvements in semen quality. However, there is little evidence to establish the durability of varicocele repair. We analyzed the durability of improvements in postoperative semen parameters following microsurgical subinguinal varicocele repair. Methods: We evaluated all men who underwent microscopic subinguinal varicocelectomy from 2015‒2019. Patients were included if they desired fertility and had a followup of at least 12 months. We assessed the baseline characteristics of these patients, as well as semen volume, total motile sperm count (TMSC), concentration, percent motility, and morphology. Semen parameters were analyzed at baseline (preoperative), approximately three months and ≥12 months postoperatively. Results: Of 105 men who underwent varicocelectomy, 18 men had a followup of at least 12 months. These men presented with median age 34.5 (27–38] years for a median followup duration of 14.5 (13–22.5) months. TMSC levels increased from 6.4 (1.1–24.5) million at baseline to 11.1 (2.4–38.4) million at approximately three months and remained similar at 12.5 (1.6–31.5) million at ≥12 months. The study is limited by its retrospective nature and limited sample size. Conclusions: Microscopic subinguinal varicocele repairs can result in durable improvements of semen quality beyond one year, as demonstrated by upgrade in median TMSC. Further studies should be performed to confirm our findings.

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Efficacy of Varicocele Repair in Different Age Groups

Cited by 11 publications

References 14 publications

Clinical factors affecting semen improvement after microsurgical subinguinal varicocelectomy: Which subfertile patients benefit from surgery?

Clinical factors affecting semen improvement after microsurgical subinguinal varicocelectomy: Which subfertile patients benefit from surgery?

Benefit of varicocelectomy in infertile men with varicocele

Semen parameter improvements after microsurgical subinguinal varicocele repair are durable for more than 12 months

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