Benefits of microsurgical repair of adolescent varicocele: comparison of semen parameters in fertile and infertile adults with varicocele.

OBJECTIVES

To compare preoperative semen parameters and the effect of microscopic varicocele repair on semen parameters in adolescents, fertile adults, and infertile adults with varicocele.

METHODS

A total of 96 patients (35 adolescents, 20 fertile adults, and 41 infertile adults) were included in the primary analysis.

RESULTS

The fertile adults had a higher sperm count than did the adolescents or infertile adults (P <0.001). In infertile adults, the percentage of normal sperm increased from 14.9% +/- 1.0% preoperatively to 21.2% +/- 2.2% at 3 months (P = 0.013) and 22.1% +/- 2.2% (P = 0.003) at 6 months. The infertile adults had a lower sperm count than did the adolescents and fertile adults at both 3 (P = 0.014) and 6 (P = 0.003) months. The postoperative sperm motility in adolescents was significantly greater than that in the infertile adults at 3 (P = 0.009) and 6 (P = 0.003) months. The proportion of sperm with normal morphology was not statistically different at either 3 or 6 months among the groups. No significant differences were detected in the increase in semen parameters at 3 or 6 months among patients before or after surgery.

CONCLUSIONS

The results of our findings suggest that after varicocele repair the degree of improvement in semen parameters is not different. However, because the baseline values of the semen parameters in adolescents were better than those in infertile adults, the postoperative values in the adolescents were superior to those in infertile adults and at least as good as those in fertile adults.