Abstract
BackgroundThe suitability of laparoscopic varicocelectomy for assisted reproductive technology depends on the improvement of semen parameters. The present study analyzed the improvement of semen parameters following laparoscopic varicocele ligation.Material and methodsA retrospective study of the laparoscopic varicocele clippings at the Department of Urology of University Hospital of Kiel between the years 2007 and 2019 was conducted. The semen analyses according to WHO standards (sperm count, density, motility and morphology) were conducted before and 12 months after surgery. Screening for surgical complications took place at the time of the follow-up seminal analysis. Included were patients with oligozoospermia, asthenozoospermia and/or teratozoospermia (group 1, OAT) or with nonobstructive azoospermia (group 2, NOA).ResultsThis study included data of 27 patients and 22 patients presented preoperative OAT (81%, group 1). Another 5 patients showed NOA (19%, group 2). Data of group 1 showed that semen parameters normalized in 32% of the patients after surgery. Significant improvement in total sperm count (p < 0.005), sperm density (p < 0.005) and total motile sperm count (p < 0.005) was observed. No deterioration of semen parameters was observed. In group 2 we detected spermatozoa in 1 case in the postoperative ejaculate. None of the patients showed complications according to the Clavien-Dindo classification, postoperative hydrocele formation or recurrence of varicocele at the time of control spermiogram.ConclusionLaparoscopic varicocelectomy is a valid therapeutic approach to improve semen parameters for further assisted reproductive techniques. Spermatogenesis may be induced for patients with NOA. Normalization of semen parameters can be achieved for patients with OAT.
Highlights
A varicocele is the dilation of the pampiniform plexus
The apparent predisposition for the development of varicoceles on the left side has been explained by the anatomy of the left internal spermatic vein, draining perpendicularly into the left renal vein and by valvular abnormalities in the left internal spermatic vein [2]
The present study analyzed the improvement of semen parameters following laparoscopic varicocele ligation
Summary
A varicocele is the dilation of the pampiniform plexus. The incidence of varicocele in the general population is between 4.4% and 22.6% but as many as 21–41% of men evaluated for primary infertility have varicoceles and of patients with secondary infertility the incidence of varicoceles is 75–81% [1]. The WHO classification of varicocele is based on the Dubin and Amelar classification (see Table 1; [3]). An impairment of the testicular function by the varicocele is presumed. The deleterious effects of the varicocele on spermatogenesis seem to be progressive. The significantly increased incidence of varicoceles in patients with secondary infertility compared to the total population supports the hypothesis of progressive damage to spermatogenesis by varicocele. A protective varicocele treatment in adolescents without pathological
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
