What is the role of pre-operative blood parameters in forecasting varicocelectomy success?

Abstract

We aimed to examine the effects of pre-operative blood values on varicocelectomy success. A total of 130 patients who underwent varicocelectomy in our clinic were retrospectively analyzed. Operation success was defined as the return of all semen parameters (concentration, progressive motility, and morphology) to normal values 6months after surgery. The patients were separated as two groups as benefiting from the treatment (Group A) and not (Group B). The best cut-off value for the neutrophil/lymphocyte ratio (NLR), which can predict varicocelectomy success, was assigned to be 2.27, with AUC of 0.859 (%95 CI 0.795-0.922). The highest sensitivity and specificity were 0.857 and 0.731 (p<0.001). The best cut-off value for the mean platelet volüme (MPV) value, which can predict varicocelectomy success, was assigned to be 9.45, with AUC of 0.729 (%95 CI 0.639-0.819). The highest sensitivity and specificity were 0.655 and 0.635 (p<0.001). Binary logistic regression analysis showed NLR ratio (odds ratio (OR): 11.2, p<0.001) and MPV (OR: 2.65, p=0.002) parameters as independent predictive factors in predicting varicocelectomy success. Our study showed that low NLR ratio (≤2.27) and high MPV (≥9.45) ratio levels may be a useful pre-operative predictive tool in identifying men who benefit most from varicocelectomy in infertile patients with varicocoele.