MP74-13 PREDICTORS OF SUCCESS AFTER MICROSCOPIC SUBINGUINAL VARICOCELECTOMY

Abstract

You have accessJournal of UrologyInfertility: Therapy1 Apr 2015MP74-13 PREDICTORS OF SUCCESS AFTER MICROSCOPIC SUBINGUINAL VARICOCELECTOMY Dane Johnson, Brooke Harnisch, Andrew Zganjar, and Jay Sandlow Dane JohnsonDane Johnson More articles by this author , Brooke HarnischBrooke Harnisch More articles by this author , Andrew ZganjarAndrew Zganjar More articles by this author , and Jay SandlowJay Sandlow More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2668AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicocele is found in 35-40% of men with infertility. Although several meta-analyses have demonstrated that varicocelectomy improves semen parameters and pregnancy rates, it is still unclear as to which patients will benefit from this procedure. The aim of this study was to determine pre-operative clinical and laboratory predictors of success of microscopic subinguinal varicocelectomy as defined by a 50% improvement in sperm concentration. METHODS An Institutional Review Board retrospective study was conducted on all patients undergoing microscopic subinguinal varicocelectomy for infertility > one year with abnormal semen parameters and palpable varicocele between 2005-2013. Demographic, clinical, and laboratory data was recorded. RESULTS A total of 185 patients were identified with both pre-operative and post-operative semen analyses. Mean sperm concentration, mean motility and total progressive motile sperm significantly improved after varicocelectomy. Multivariate logistic regression analysis demonstrated that grade 3 varicocele was a significant predictor of 50% improvement in sperm concentration (OR 3.85; 95% CI 1.69 to 8.82, p=0.0014). Age of patient, age of female partner, body mass index, length and type of infertility, pre-operative hormones and habit history were not associated with significant increase in sperm concentration. Pregnancy data was available for 118 patients. Of these patients 40 (34%) achieved pregnancy via natural conception. CONCLUSIONS Microscopic subinguinal varicocelectomy results in improvement of multiple semen parameters with overall pregnancy rate of approximately 50%. The presence of grade 3 varicocele, irrespective of other pre-operative variables, predicts the most successful increase in sperm concentration. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e944 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dane Johnson More articles by this author Brooke Harnisch More articles by this author Andrew Zganjar More articles by this author Jay Sandlow More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...