Abstract
Prevalence of varicocele is approximately 15.1% of the general population. Studies showed that surgical correction of clinically palpable varicocele could improve the semen parameters. However, there is scarce of study to demonstrate post-operative outcome of varicocelectomy among the patients with abnormal semen parameter. Therefore, this study tried to compare the microscopic changes in sperm concentration, sperm motility, and sperm morphology before and after varicocelectomy. This quasi-experimental study was done in Urology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2014 to April 2016. Forty five patients with clinically palpable varicocele were finally includedin the study. Semen parameters of these patients were assessed by following the World Health Organization′s 5th manual of semen parameter, 2010. Subinguinal varicocelectomy was performed in every case. Follow up was done three months and six months after surgery. Data were analysed with statistical software SPSS 20 and level of significance was assessed by paired t-test.Almost 60.0% of patients were from 25 to 35 years age group. Of them, 87.1% patients were presented with left-sided varicocele, and 80% were grade III. All the patients showed oligospermia on semen analysis, whereas the number of abnormal sperm motility and abnormal morphology was 39, and 09, respectively. After surgical correction of varicocele, mean improvement of sperm concentration, motility and morphology found in 35 patients (77.7%), 31 patients (79.4%) and six patients (66.6%) respectively. The improvement was statistically significant (p<0.05). This study showed that surgical treatment could lead to the betterment of semen parameters in patients with clinically palpable varicocele, which will guide in deciding the management of varicocele patients presented with abnormal semen parameter. However, to recommend varicocelectomy as a most useful procedure in treating infertility cases; further longitudinal studies are recommended to establish the impact of varicocelectomy on
Highlights
Varicocele is known to be an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus of the spermatic cord.[1]
There are studies which showed that surgical correction of clinically palpable varicocele could improve the semen parameters for some patients.[11,12,13]
Patients having age between 18 to 45 years; clinically palpable varicocele; with any abnormal semen parameter: sperm concentration, motility or morphology were included in the study
Summary
Varicocele is known to be an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus of the spermatic cord.[1] It is the most frequent abnormal physical finding in men who present for an infertility evaluation.[2] The prevalence of varicocele is approximately 15.1% in the general population, ranging from 19.0% to 41.0% in accounting the primary and 45.2% to 81.1% with secondary infertility[3]. In a contemporary study of 7,035 military recruits fromsix European countries showed that the prevalence is 15.7%. Only 1.1% had bilateral disease, and 0.2% had anisolated right-sided varicocele on physical examination[4].It has been reported that only 20.2% of men with documented varicoceles usually suffer with the fertility problems. There are studies which showed that surgical correction of clinically palpable varicocele (varicocelectomy) could improve the semen parameters for some patients.[11,12,13]
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