Factors Related to Improvement or Normalization of Semen Parameters after Microsurgical Subinguinal Varicocelectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To determine factors related to improvement or normalization of semen parameters after varicocelectomy, we retrospectively analyzed patients who underwent semen evaluation before and after varicocelectomy. MATERIALS AND METHODS: A total of 133 patients undergoing left-sided microsurgical subinguinal varicocelectomy for clinically palpable varicoceles with at least one abnormal semen parameter were included in this study. Preoperative and postoperative semen parameters were analyzed. We defined improvement in semen parameters as a greater than 20% change in preoperative values. Several potential predictors of improvement or normalization of each semen parameter were analyzed by multivariate logistic regression model. RESULTS: Of 133 patients, 64, 105, and 68 patients had abnormal sperm concentration, motility, and morphology, respectively. Postoperative mean values of each parameter were significantly improved after varicocelectomy. In subgroup analyses of the patients with oligospermia, asthenospermia, or teratospermia, improvement in each parameter (concentration, motility, morphology) was observed in 65.6% (42/64), 71.4% (75/105), and 51.5% (35/68) of the patients, respectively, and normalization of each parameter was observed in 42.2%, 29.5%, and 57.4% of the patients, respectively. Absence of testicular size discrepancy and preoperative sperm concentration were independent predictive factors for normalization of the sperm concentration. For improvement of sperm motility, a significant correlation was found with grade of varicocele. Meanwhile, for normalization of sperm motility, significant correlations were found with age and preoperative sperm motility. CONCLUSIONS: Substantial improvement and normalization in each semen parameter was observed after microsurgical subinguinal varicocelectomy. There were different independent predictive factors for improvement or normalization of each semen parameter.