https://doi.org/10.4081/aiua.2023.11580

Bilaterality of varicocele: The overlooked culprit in male infertility. Case series study

Vol. 95 No. 3 (2023)
Published: September 12, 2023
Male infertility, Varicocele bilaterality, Varicocelectomy, Semen parameters
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Authors

Khaled Mohamed Almekaty
Urology Department, Tanta University, Tanta, Egypt.
Ahmed Mostafa Elsharkawy
https://orcid.org/0000-0001-9069-5181
Radiology Department, Tanta University, Tanta, Egypt.
Mohamed Hasan Zahran
Mansoura Urology and nephrology centre, Mansoura University, Mansoura, Egypt.
Maged Mostafa Ragab
Urology Department, Tanta University, Tanta, Egypt.
Ayman Sayed Rashed
https://orcid.org/0000-0003-1994-2228
Urology Department, 6th of October University, Cairo, Egypt.
Mahmoud Mohamed Soliman
https://orcid.org/0000-0002-3268-7412
Obstetrics and Gynecology Department, Cairo University, Cairo, Egypt.
Khaled Abdelaziz Salem
Urology Department, Tanta University, Tanta, Egypt.
Ahmed Fayez Ghaith
dr_ahmedfayez@yahoo.com
https://orcid.org/0000-0002-9102-1821
Urology Department, Tanta University, Tanta, Egypt.

Objectives: Varicocele is the most common correctable cause of male infertility that always has been a debatable subject as regards how it affects fertility and the best way to treat it. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome. This study aimed to objectively assess varicocele bilaterality in infertile men aiming to improve treatment outcome in this cohort of patients. Methods: This prospective study was conducted between January 2019 and January 2022 including infertile males with varicoceles. Assessment of missed concomitant contralateral varicocele done pre-operatively by Color Doppler Ultrasound and intraoperatively by intraoperative Doppler device and measurement of maximal vein diameter of contralateral side. Results: A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the study population, bilaterality of varicocele was found to be as high as 98.5% (324/329). Repeat CDUS strongly correlated with the intraoperative measured varicocele diameter (r = 0.9, p < 0.001). Moreover, sperm parameters showed significant improvement 3 and 6 months post varicocelectomy. Normal pregnancy after 1 year of surgery occurred in 118 cases (35.9%). Conclusions: Varicocele bilaterality in infertile men is underreported. Thorough assessment by expert radiologists and andrologists is of paramount importance not to miss significant pathology or hazard treatment outcome.

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How to Cite

Almekaty, K. M., Elsharkawy, A. M., Zahran, M. H., Ragab, M. M., Rashed, A. S., Soliman, M. M., Salem, K. A., & Ghaith, A. F. (2023). Bilaterality of varicocele: The overlooked culprit in male infertility. Case series study. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11580
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