PD09-11 VEIN DIAMETER ON ULTRASOUND AS PREDICTOR OF SEMEN PARAMETER IMPROVEMENT AFTER VARICOCELECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022PD09-11 VEIN DIAMETER ON ULTRASOUND AS PREDICTOR OF SEMEN PARAMETER IMPROVEMENT AFTER VARICOCELECTOMY Leon Telis, Alan Paniagua Cruz, Kirolos Meilika, Hira Chaudhry, Michael Huaman, and Boback M. Berookhim Leon TelisLeon Telis More articles by this author , Alan Paniagua CruzAlan Paniagua Cruz More articles by this author , Kirolos MeilikaKirolos Meilika More articles by this author , Hira ChaudhryHira Chaudhry More articles by this author , Michael HuamanMichael Huaman More articles by this author , and Boback M. BerookhimBoback M. Berookhim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002535.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Clinical presence and grade of varicocele has been associated with the degree of spermatogenic response to varicocelectomy. There have been no objective pre-operative factors that have been found to correlate with spermatogenic improvement post-varicocelectomy. We aim to determine whether preoperative venous diameter on ultrasound may predict semen parameter improvement post-varicocelectomy. METHODS: We performed a retrospective chart review of a single-surgeon cohort of patients undergoing microsurgical varicocelectomy to assess the impact of pre-operative ultrasound varicocele diameter on changes in semen analysis. Sonography was performed at local centers with experience in scrotal Doppler sonography. Maximal internal spermatic vein diameters were reported. Paired t-test and Wilcoxon signed-rank test were used to analyze changes in pre- and post-operative semen parameters. Paired t-test was used to further analyze changes in pre- and post-operative semen parameters among unilateral vs bilateral varicocelectomy. Statistical significance was defined as p <0.05. Kendall rank coefficient was performed to assess correlation of varicocele clinical grade and vein diameter on ultrasound. RESULTS: The last 180 consecutive patients who underwent subinguinal microsurgical varicocelectomy were evaluated. Median age of patients was 32 years (range 19-57). 56 patients with available post-operative semen analyses underwent bilateral repair and 49 patients underwent unilateral repair. Mean time from surgery to post-operative semen analysis was 5.4 months. Men who underwent varicocelectomy with vein diameter >3.5 mm had a significant improvement in sperm concentration. Improvement in sperm motility and morphology was also noted in this cohort and approached statistical significance. Those with varicoceles <3.5 mm did not demonstrate an improvement in semen parameters. Significant improvement in semen concentration and morphology was noted among patients undergoing bilateral repair. There was a statistically significant association between clinical and radiographic varicocele size (tau = 0.391, p <0.001). CONCLUSIONS: We identified an improvement in semen analysis parameters after varicocele repair in men with clinical varicoceles with venous diameter >3.5 mm on ultrasound. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e181 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leon Telis More articles by this author Alan Paniagua Cruz More articles by this author Kirolos Meilika More articles by this author Hira Chaudhry More articles by this author Michael Huaman More articles by this author Boback M. Berookhim More articles by this author Expand All Advertisement PDF DownloadLoading ...