https://doi.org/10.4081/aiua.2024.12082

Microsurgical varicocelectomy efficacy in treatment of men with primary and secondary infertility (retrospective study)

Vol. 96 No. 1 (2024)
Submitted: November 14, 2023
Accepted: November 28, 2023
Published: February 16, 2024
Varicocele, varicocelectomy, primary infertility, secondary infertility
Abstract Views: 378
PDF: 214
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Authors

Shomarufov Azizbek
doctor.shomarufov@gmail.com
https://orcid.org/0000-0001-9271-0808
Urology Department of Tashkent Medical Academy; Republican Specialized Scientific-Practical Medical Center of Urology, Tashkent City, Uzbekistan.

Introduction and objectives: Varicocele is the most common treatable cause of male infertility. The study aimed to compare varicocelectomy efficacy in men with primary (PI) and secondary infertility (SI).
Patients and Methods: Medical records of 100 men suffering from PI and SI and having varicocelectomy at the Republican Specialized Scientific-Practical Medical Center of Urology were retrospectively selected and analyzed. Patients were divided into 2 groups. Group I included 58 men with PI and Group II 42 men with SI. Preoperative clinical characteristics and semen parameters before and after varicocelectomy were analyzed and compared between groups.
Results: Analysis revealed that the mean age of patients of group I was significantly lower (p<0.001) and the duration of infertility was accurately shorter (p<0.01) than those of group II. Main semen parameters increased significantly in group I (e.g., sperm concentration increased by 50%, from 62.2 ± 8.7 to 93.5 ± 10.0 M/ml, and total motile sperm count increased by 113%, from 76.7±17.1 to 163.4±27.8 M p<0.05), while in group II only rate of progressive motile sperm increased significantly (by 107%, from 13.5± .6 to 28.0±5.2% p<0.05). We identified a significant difference in varicocelectomy efficacy between group I and group II in change of total motile sperm count (by 113% vs 74% respectively, p<0.01). We also revealed a discrepancy between groups in correlation ratio (r) between initial and post-surgical percent of progressive motile sperm.
Conclusions: Patients with SI were older and had longer infertility period. Varicocelectomy resulted in significant semen parameters improvement in patients with PI. In patients with SI, only a percent of progressively motile sperm improved significantly. It indicates that advanced male age and long infertility duration may have a negative impact on varicocelectomy success.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Salonia A, Bettocchi C, Capogrosso P, et al. European Association of Urology. Sexual and reproductive health. Arnhem, The Netherlands; EAU, 2023. Available at: uroweb.org/guidelines/sexual-and-reproductive-health
Wein AJ, Kavoussi LR, Novick AC, et al. Campbell-Walsh Urology. 11th ed. Saunders, Elsevier, Philadelphia; 2016. pp. 636-37.
Abdel-Meguid TA, Al-Sayyad A, et al. Does varicocele repair improve male infertility? An evidence-based perspective from a randomized, controlled trial. Eur Urol. 2011; 59:455-61. DOI: https://doi.org/10.1016/j.eururo.2010.12.008
Baazeem A, Belzile E, Ciampi A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role ofvaricocele repair. Eur Urol. 2011; 60:796-808. DOI: https://doi.org/10.1016/j.eururo.2011.06.018
Ficarra V, Cerruto MA, Liguori G, et al. Treatment of varicocele in subfertile men: the Cochrane review—a contrary opinion. Eur Urol. 2006;49:258-63. DOI: https://doi.org/10.1016/j.eururo.2005.11.023
Persad E, O'Loughlin CA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;23;CD000479. DOI: https://doi.org/10.1002/14651858.CD000479.pub6
Çayan S, Shavakhabov S, Kadioglu A. Treatment of palpable varicocele review in infertile men: a meta-analysis to define the best technique. J Androl. 2009;30:33-40. DOI: https://doi.org/10.2164/jandrol.108.005967
Fukuda T, Miyake H, Enatsu N, et al. Assessment of Timedependent Changes in Semen Parameters in Infertile Men After Microsurgical Varicocelectomy. Urology. 2015;86:48-51. DOI: https://doi.org/10.1016/j.urology.2015.04.014
Walsh TJ, Wu AK, Croughan MS, Turek PJ. Differences in the clinical characteristics of primarily and secondarily infertile men with varicocele. Fertil Steril. 2009;91:826-830. DOI: https://doi.org/10.1016/j.fertnstert.2007.12.071
World Health Organization. WHO Laboratory Manual for the Examination and processing of human semen. 5th edition. Available from: https://iris.who.int/handle/10665/44261
Jungwirth A, Giwercman A, Tournaye H, et al. European Association of Urology Guidelines on Male Infertility: The 2012 Update. Eur Urol. 2012; 62:324-332. DOI: https://doi.org/10.1016/j.eururo.2012.04.048
World Health Organization. Body Mass Index. 2006. Available from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index
Argawal A, Deepinder F, Cocuzza M, et al. Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach. Urology. 2007;70:532-8. DOI: https://doi.org/10.1016/j.urology.2007.04.011
Samplaski MK, Yu C, Kattan MW, et al. Nomograms for predicting changes in semen parameters in infertile men after varicocele repair. Fertil Steril. 2014;102:68-74. DOI: https://doi.org/10.1016/j.fertnstert.2014.03.046
Bozhedomov VA, Shomarufov AB, Bozhedomova GE, et al. [Varicocele and reproductive function: pathozoospermia treatment (a prospective comparative study)].[Article in Russian]. Urologiia. 2021;5:62-8. DOI: https://doi.org/10.18565/urology.2021.2.62-68
Bozhedomov VA, Shomarufov AB, Bozhedomova GE, et al. [Varicocele and reproductive function: epidemiology and infertility risk (the examination of 3632 patients)].[Article in Russian]. Urologiia 2021;3:122-8. DOI: https://doi.org/10.18565/urology.2021.3.122-128
Gowri V, Venkiteswaran KP, Al-Zakwani I, et al. Comparison of the Demographics, Semen Parameters and Hormone Profiles in Men with Primary and Secondary Infertility. Sultan Qaboos Univ Med J. 2010; 10:350-353.

How to Cite

Azizbek, S. (2024). Microsurgical varicocelectomy efficacy in treatment of men with primary and secondary infertility (retrospective study). Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12082
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