Assessment of Palomo's operative method for infertile varicocele.

Abstract

Palomo's operative method was employed in the surgical treatment of 58 cases with infertile varicocele, and the operative method and therapeutic results were assessed. With the lapse of time after operation, statistically significant improvement was achieved in the sperm density and sperm motility. The post-operative impregnation rate was 55.2%. When the pre-operative sperm motility index had been 20% or less, the post-operative impregnation rate was 23%, which was significantly lower than the overall rate of 55.2%. Thus, the pre-operative sperm motility index is a good indicator of the post-operative capacity for impregnation. Even in patients with severe oligozoospermia (< 5 x 10(6) ml-1), a post-operative impregnation rate of 45.5% was obtained. Thus, their prognosis is by no means hopeless. Study of the cross-sectional profile of the internal spermatic vessels revealed the possibility of overlooking small internal spermatic venous branches. Therefore, Palomo's method was concluded to be excellent as an approach performed under direct visual observation. Palomo's method did not cause any complication of testicular atrophy and improved the fertility potential.