Assessment of the clinical significance of right subclinical varicocele in subfertile men

ABSTRACT

Purpose: Recent progress in diagnostic methods has revealed a higher incidence of subclinical right varicocele, the clinical significance of which is controversial in the field of male infertility. As such, we assess the fertility after varicocelectomy in patients with right subclinical varicocele. Patients and methods: A total of 101 infertile patients underwent either left unilateral [group A] or bilateral [group B] varicocelectomy. The former group included 43 patients diagnosed by clinical examination only to have left clinical varicoccle. The later group included 58 patients diagnosed to have left clinical varicocele and right subclinical varicocele based on scrotal Doppler examination. A significant difference was found in both the improvement in postoperative semen characteristics and the spontaneous pregnancy rate between the sonographically diagnosed bilateral and the clinically diagnosed unilateral groups. These data suggest that the limited results of left varicocelectomy in the infertile patients diagnosed by physical examination alone may be in part due to the overlooked subclinical right varicocele. The subclinical right varicocele can affect spermatogenesis in Therefore, we compared the results of varicocelectomy in patients diagnosed to have left clinical varicocele by physical examination only and in patients diagnosed to have left clinical varicocele and right subclinical varicocele based on scrotal Doppler examination