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Clinical study of varicocele: Statistical analysis and the results of long‐term follow‐up
Author(s) -
Onozawa Mizuki,
Endo Fumiyasu,
Suetomi Takahiro,
Takeshima Hitoshi,
Akaza Hideyuki
Publication year - 2002
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2002.00501.x
Subject(s) - varicocele , medicine , luteinizing hormone , semen analysis , urology , follicle stimulating hormone , semen , sperm , infertility , pregnancy rate , gynecology , hormone , andrology , pregnancy , genetics , biology
Background: The results of clinical examinations of varicocele and the clinical outcome of varicocelectomy conducted at Tsukuba University Hospital, Tsukuba City, Japan were analyzed. Methods: The subjects of the present study were sixty‐four infertile male patients with varicocele who visited our hospital from 1991to 1999. A physical examination, semen analysis and hormonal evaluation were performed for each patient. Patients selected their preferred type of treatment (varicocelectomy or conservative treatment) after providing their informed consent. Results: The age of the patients was 34.1 ± 5.1(mean ± standard deviation [s.d.]) years, and the infertile duration was 4.2 ± 3.0 (mean ± s.d.) years. Fifty‐one cases were left‐sided; 13 were bilateral. Mean sperm density (¥ 10 6 /mL) was 37.2 for Grade I, 21.3 for Grade II and 9.4 for Grade III. Sperm density was significantly lower in the higher‐graded patients ( P = 0.008). Varicocelectomy was performed in 31 cases; the postoperative/preoperative ratio of sperm density was significantly higher in the higher‐graded varicocele ( P = 0.04), and the peak/base ratio of follicle‐stimulating hormone (FSH) after luteinizing hormone‐releasing hormone (LH‐RH) stimulation was significantly decreased after varicocelectomy ( P = 0.007). The pregnancy rate in the partners of the varicocelectomized group (60%) was significantly higher than in the conservatively treated group (28%) P = 0.04; the mean follow‐up duration was 76.2 months. Conclusion: These results show that varicocele should influence spermatogenesis, therefore altered spermatogenesis could be effectively treated by varicocelectomy, and varicocelectomy should induce a higher probability of pregnancy.