Varicocelectomy and Male Fertility: Comparison of Semen Quality and Recurrence of Varicocele Following Varicocelectomy by Two Techniques

Publisher Website
Google Scholar
Abstract
Infertile men (238) aged 20-50 yr, suffering from left varicocele underwent internal spermatic vein high ligation. The patients were operated on using Ivanissevich technique, IT, (210 patients) or the Bernardi technique, BT, (28 patients). In the BT group recurrences were found in 7.1% as against 28% in the IT group. The low rate of recurrence found in the BT group might be due to the fact that the patients were under local anesthesia and collaborated with the surgeon. Varicocelectomy was followed by improvement in sperm quality 3-9 mo. after operation. Improvement among the fertile men was more rapid than among the infertile men. Sperm concentration improved significantly in 50% of the cases. Sperm motility improved in 37% of the cases; morphology improved in 29% of the cases. Sperm vitality was identical in response to that of motility. Varicocelectomy did not cause any change in the seminal plasma constituents (volume, pH, fructose). Improvement in sperm quality was identical in the IT and BT groups, as was the impregnation rate. Couples (94) reported pregnancies 39.5%, which occurred within 2 yr after operation (12 .+-. 1.5 mo. mean .+-. SEM [standard error of the mean]). No correlation was found between size of varicocele and improvement in sperm quality and fertilizing capacity.