Varicocele and male subfertility: prognostical criteria in the surgical treatment.

A retrospective analysis of 324 infertile patients who underwent the surgical treatment of varicocele was conducted. Patients were divided into groups according to the presence or not of other pathological conditions, associated with varicocele: genital inflammation, left testicular hypotrophy, elevated FSH, history of cryptorchidism and azoospermia. Age was also considered. The overall pregnancy rate was 34.2% and the semen improvement was obtained in 181 cases (52.7%). Higher percentages were attained in patients with varicocele only: 56.9% pregnancy rate, 78% sperm improvement. The analysis of the results allowed us to define a prognostical index and to offer the criteria of operability in an infertile patient with varicocele.

Clinical study and results of surgical treatment in 146 oligospermic men with varicocele.

Data of 146 infertile men undergoing surgical treatment for varicocele are reported. Patients with the following features were treated by surgery: normal FSH (follicle-stimulating hormone) not severe hypotrophy of the left testis and normal right testis; absence of azoospermia; absence of autosome or sex chromosome alterations; absence of signs of genital inflammation. A clear-cut improvement in the condition of seminal secretion was obtained both in oligospermic patients with less than 10 millions spermatozoa per ml preoperatively, and in patients with a higher number of spermatozoa. Particularly, a marked improvement in the valid motility and morphology of spermatozoa was observed. The biological index of a successful treatment in correcting infertility is represented by the high number (51) of successful pregnancies in the wives of operated patients. It is to be underlined that measurements of spermatic vein pressure, phlebography and intraoperative cineradioscopy completely avoid recurrence that otherwise affects about 5 to 6% of operated patients.