Evaluation of the Effect of the Number and Size of Veins Ligated at Left Sided Microsurgical Inguinal Varicocelectomy on the Semen Analysis Outcomes

Abstract

Backgrounds and Objectives: The most common correctable cause of male infertility is varicocele. The inguinal microsurgical techniques are innovative techniques that allow the ligation of all of the veins. Diameter and number of the veins ligated seems to be effect the treatment results. The purpose of this study was to investigate the effect of the number and diameter of ligated veins on the changes of semen analysis parameters. Materials and Methods: In a descriptive analytical study, 50 patients with varicocele were studied. Preoperative semen analysis was performed in two steps. In all of them, inguinal microscopic was done. Results were compared with semen analysis after 6 months. Results: Fifty patients with mean age 30±0.7 years were enrolled. The patient’s complaint was pain in 28% of case and infertility in 72% of case. Varicocele grading was 12% grade 1, 42% grade 2 and 46% grade 3. A significant difference was seen in the sperm count, morphology and motility before and after the surgery. There were no significant differences in other parameters of semen analysis. In patients with over 10 ligated veins, a significant improvement in the sperm count, morphology and motility was seen. In other patients with less than 10 ligated veins, the improvement was seen in the sperm count only. The diameter of the ligated veins had no effect on the changes in semen analysis. Conclusion: Our results indicate that the varicocelectomy has improving effects on the semen analysis parameters. Improvement in the sperm count, morphology and motility was occurred with increasing the number of ligated veins. However, venous diameters had no effect on the semen analysis parameters.