Lamy Salahadin H, Mohammedkhalil Abdullah K, Bafaqeeh Hashim M, Alsuwaida Shatha A, Alhindi Adel S Khan, Maqboli Sara A, Khan Muhammad A
Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Urol Ann. 2023 Jul-Sep;15(3):256-260. doi: 10.4103/ua.ua_49_22. Epub 2023 Jun 16.
Varicocele, the dilation of the pampiniform plexus of the spermatic cord. It is discovered incidentally in most patients. Symptoms vary, but its impact is especially experienced in the field of fertility and reflected in semen parameters. Varicocelectomy is a surgical approach to correct the varicocele, however, reports are conflicting regarding its success. Our aim was to evaluate the efficacy of varicocelectomy on semen parameters and conception rates in patients who underwent surgery and its association with comorbidities such as diabetes, hypertension, and obesity.
This cross-sectional study included the complete medical records of 86 patients. Data collection form included the patient's age, body mass index (BMI), chronic diseases, smoking, surgical history, medication usage, and the reason for performing surgery. Presurgical and postsurgical semen parameters were evaluated 3 months before surgery and an average of 6 months postoperatively. Data were analyzed with SPSS, Chi-square test, and independent and paired -test.
No significant difference was found between primary and secondary infertility regarding semen analysis, postoperative semen analysis indicated an improvement in semen motility at 180 min with no effect on other parameters. Using spontaneous intercourse or fertilization (IVF) after varicocelectomy was significantly associated with increasing conception rates irrespective of the type of infertility. Diabetes, hypertension, BMI, and smoking did not appear to affect semen parameters.
Patients who underwent varicocelectomy had improved sperm motility at 180 min and subsequently had a higher chance of successful conception either through spontaneous intercourse or IVF. Further studies are needed to understand the relationship between conception and sperm motility. Semen parameters were not affected if the patient had comorbidities such as diabetes and hypertension. Furthermore, smoking and BMI did not appear to affect the conception rate.
精索静脉曲张是精索蔓状静脉丛的扩张。大多数患者是偶然发现的。症状各不相同,但其影响在生育领域尤为明显,并反映在精液参数上。精索静脉结扎术是纠正精索静脉曲张的一种手术方法,然而,关于其成功率的报道相互矛盾。我们的目的是评估精索静脉结扎术对接受手术患者精液参数和受孕率的疗效,以及它与糖尿病、高血压和肥胖等合并症的关联。
这项横断面研究纳入了86例患者的完整病历。数据收集表包括患者的年龄、体重指数(BMI)、慢性病、吸烟情况、手术史、用药情况以及手术原因。术前和术后的精液参数分别在手术前3个月和术后平均6个月进行评估。数据采用SPSS、卡方检验以及独立样本和配对样本检验进行分析。
在精液分析方面,原发性不孕和继发性不孕之间未发现显著差异,术后精液分析表明,180分钟时精液活力有所改善,而对其他参数无影响。精索静脉结扎术后采用自然性交或体外受精(IVF)与受孕率增加显著相关,无论不孕类型如何。糖尿病、高血压、BMI和吸烟似乎并未影响精液参数。
接受精索静脉结扎术的患者在180分钟时精子活力有所改善,随后通过自然性交或IVF成功受孕的机会更高。需要进一步研究以了解受孕与精子活力之间的关系。如果患者患有糖尿病和高血压等合并症,精液参数不受影响。此外,吸烟和BMI似乎并未影响受孕率。