What is the role of pre‐operative blood parameters in forecasting varicocelectomy success?

Abstract

Background We aimed to examine the effects of pre‐operative blood values on varicocelectomy success. Materials and methods A total of 130 patients who underwent varicocelectomy in our clinic were retrospectively analyzed. Operation success was defined as the return of all semen parameters (concentration, progressive motility, and morphology) to normal values 6 months after surgery. The patients were separated as two groups as benefiting from the treatment (Group A) and not (Group B). Results The best cut‐off value for the neutrophil/lymphocyte ratio (NLR), which can predict varicocelectomy success, was assigned to be 2.27, with AUC of 0.859 (%95 CI 0.795–0.922). The highest sensitivity and specificity were 0.857 and 0.731 (p < 0.001). The best cut‐off value for the mean platelet volüme (MPV) value, which can predict varicocelectomy success, was assigned to be 9.45, with AUC of 0.729 (%95 CI 0.639–0.819). The highest sensitivity and specificity were 0.655 and 0.635 (p < 0.001). Binary logistic regression analysis showed NLR ratio (odds ratio (OR): 11.2, p < 0.001) and MPV (OR: 2.65, p = 0.002) parameters as independent predictive factors in predicting varicocelectomy success. Discussion and conclusion Our study showed that low NLR ratio (≤2.27) and high MPV (≥9.45) ratio levels may be a useful pre‐operative predictive tool in identifying men who benefit most from varicocelectomy in infertile patients with varicocoele.

Can preoperative inflammatory markers predict the success of varicocelectomy?

“…In another study, Erdoğan et al reported that the group whose semen parameters improved after varicocelectomy included patients with low NLR and high MPV. They determined the cutoff value as 2.27 for NLR (Erdogan et al, 2021). Similarly, in this study, NLR and MLR were found to be significant parameters in predicting the success of varicocelectomy.…”

The effect of systemic inflammatory index and systemic inflammatory response index on success of varicoselectomy

“…9 In previous studies in patients with varicocele, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) were used to predict prognosis. 10 In addition, the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) in inflammatory diseases and various cancers have been studied as more complex inflammatory markers. 11,12 Since 2014, a new index called the SII (neutrophil × platelet/lymphocyte) has been used.…”