Is it worthwhile to operate on subclinical right varicocele in patients with grade II-III varicocele in the left testicle?

J Assist Reprod Genet. 2005 May;22(5):227-31. doi: 10.1007/s10815-005-4926-2.

Abstract

Purpose: To determine whether repair of subclinical varicoceles in the right testicle results in significant seminal improvement in patients with clinical left varicocele.

Methods: Patients were divided into two groups: Group I (unilateral varicocelectomy) and Group II (bilateral varicocelectomy-subclinical left varicocele). The mean sperm concentration before treatment was higher in Group I (21.01 +/- 19.1) compared to Group II (5.7 +/- 10.7) (p = 0.04).

Results: An increase in volume was detected in the left testicle of patients in Group I (17 +/- 7.9 vs. 22.81 +/- 8.2; p = 0.04) and in the right testicle of patients in Group II (18.4 +/- 6.2 vs. 22.3 +/- 6.5; p = 0.04). Although the mean postoperative sperm concentration in Group I increased slightly (25.7 +/- 22.8), the mean sperm concentration in Group II increased significantly (30.32 +/- 9.8; p = 0.03). Pregnancy rate was higher in Group II (66.7%) compared to Group I (33.3%).

Conclusions: Even a small, subclinical unrepaired varicocele continues to have a detrimental effect on bilateral testis function in a patient with grade II-III left varicocele.

MeSH terms

  • Adult
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Infertility, Male / blood
  • Infertility, Male / pathology
  • Infertility, Male / surgery
  • Luteinizing Hormone / blood
  • Male
  • Pregnancy
  • Prospective Studies
  • Sperm Count
  • Sperm Motility / physiology
  • Spermatogenesis
  • Testis / pathology
  • Testis / surgery
  • Testosterone / blood
  • Varicocele / blood
  • Varicocele / pathology
  • Varicocele / surgery*

Substances

  • Testosterone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone