Effect of bilateral high ligation on ultrastructure of sperms by electromicroscopic examination

ABSTRACT

One hundred and three patients with primary varicocele more on left side than right side presented to out patient clinics of many hospitals in the age range from 25 years to 55 years [average age 30 +/- 4]. Diagnosis of varicocele was evaluated by clinical examination, ultrasonography, Doppler flowmetery and Testicular vein venography. All patients were subjected to bilateral retroperitoneal ligation of testicular veins and inguinal ligation of testicular veins. They were followed for 12 month to 39 months. Electron microscopic examination of seminal fluid, was done before and after surgery 3, 6, 12 months, to see the effect of highligation on ultra structure of sperms. Success was achieved in 40% of patients in excellent manner [increase in number of sperms, decrease in percentage of abnormal forms, increase in mothility of sperms] about 50% of patients showed mild improvement [mild increase in number of sperms, percentage of abnormal forms was still high, motility of sperms remained minimal]. Ten percent showed no improvement at all, even some of them schieved worse results. In our series, bilateral high ligation showed better results than unilateral ligation of left testicular vein alone and it remains the operation of choice in the treatment of varicocele with oligoathenospermia especially in selected young aged patient