La varicocèle de l’adulte: aspects anatomo-cliniques et resultats therapeutiques au service d’urologie-andrologie du CHU de Conakry, Guinee

Abstract

ObjectiveTo describe the clinical aspects of varicocele and to evaluate the outcome of its treatment at the Department of Urology and Andrology of Conakry University Hospital, Republic of Guinea. Patients and MethodsThis prospective study included 119 patients with varicocele operated on at the Department of Urology and Andrology of Conakry University Hospital over a one-year period. Clinically, the varicoceles were classified into four grades according to the classification of Dubin and Amelar. All patients received at least one semen analysis pre- and postoperatively. ResultsThe mean age of the patients was 38 (range 22–53) years. In 80.7% (n=96) of the cases the varicocele was detected in the course of an infertility consultation. The varicocele was located on the left side in 84.9% (n=101) of the cases, while it was bilateral in 15.1% (n=18). Preoperative semen analysis was normal in 5% of the cases. Oligo-astheno-teratozoospermia seen in 46.2% (n=55) of the patients was the most frequently found anomaly. All patients underwent surgical treatment using the Ivanissevich procedure. After a mean follow up of 17 months conducted on 113 patients, significant improvement in sperm quality was observed in 67 patients with normalization of the sperm count in 33 of them. However, no improvement was noted in 6 out of 8 patients who had presented with azoospermia. Forty-two (35.3%) spontaneous pregnancies were recorded during the follow-up period. ConclusionVaricocele is a common condition in our daily practice. It is most commonly detected in the course of consultation for infertility. The spermatic profile is that of oligo-astheno-teratozoospermia. Surgical treatment significantly improves the hypofertile patient's fertility.