Correlation of Testicular Volume and Semen Parameter with Varicocele Grades in Mosul City: A Case-Control Study

Abstract

Background: Varicocele is a status of abnormal dilatation and sinuosity of the pampiniform plexus that leading to a decrease in the volume of the impacted testicle. Approximately 15–20% and 35% of healthy adult males and men with primary infertility are affected respectively. It was considered as one of the surgically correctible causes of male infertility. Objective: The objective of the current study was to investigate the correlation of testicular volume and semen parameter with varicocele grades in patients with varicocele attending the Department of Urology of Al-Jumhory Teaching Hospital. Materials and Methods: The current study was a case-control study which was conducted in the Department of Urology at Al-Jumhory Teaching hospital, Mosul city, Iraq, during the period January 2018 to June 2019. A total of 250 participants were enrolled in this study (200 patients with clinical varicocele and 50 healthy volunteers). Seminal fluid analysis, testicular size measured by ultrasound scanning, and varicocele grading according to standard criteria based on clinical examination and Doppler study of genitalia were performed for all participants. Statistical analysis was applied to test the correlation of testicular size and seminal fluid parameter with varicocele grade. Result: Patients with varicocele were classified into three groups based on the grade of varicocele: Group I included 22 patients with Grade 1 varicocele (12%), Group II included 82 patients with Grade II varicocele (38%), and Group III included 96 patients with Grade III varicocele (50%). Besides, Group IV was assigned to healthy volunteers (50) as a control group. Sperms with normal motility and morphology were 33% and 32%, 25% and 25%, 10% and 15%, 60% and 65% in group I, group II, group III, and group IV respectively. There were significant statistical differences (P-value<0.05) between the testicular volumes of both Group II and Grade III and control groups. Conclusion: Men with large varicocele had significantly abnormal semen parameters as well as decreased ipsilateral testicular volumes compared to men with small varicocele or healthy men.