Crafa Andrea, Russo Marco, Cannarella Rossella, Gül Murat, Compagnone Michele, Mongioì Laura M, Cannarella Vittorio, Condorelli Rosita A, Vignera Sandro La, Calogero Aldo E
Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.
Department of Physics and Astronomy, University of Catania, Catania 95123, Italy.
Asian J Androl. 2025 Jan 1;27(1):52-58. doi: 10.4103/aja202438. Epub 2024 Aug 9.
Varicocele is a prevalent condition in the infertile male population. However, to date, which patients may benefit most from varicocele repair is still a matter of debate. The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair, defined as an improvement in total motile sperm count (TMSC). We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair, collected from the Department of Endocrinology, Metabolic Diseases and Nutrition, University of Catania (Catania, Italy), and the Unit of Urology at the Selcuk University School of Medicine (Konya, Türkiye). The predictive analysis was conducted through the use of the Brain Project, an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available. Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value. For patients with preintervention TMSC below 5 × 10 6 , improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was >5 × 10 6 . From the preintervention TMSC alone, we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%. Varicocele grade and serum follicle-stimulating hormone (FSH) levels did not play a predictive role, but it should be noted that all patients enrolled in this study were selected with intermediate- or high-grade varicocele and normal FSH levels. In conclusion, preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate- or high-grade varicoceles and normal FSH levels.
精索静脉曲张在男性不育人群中很常见。然而，迄今为止，哪些患者可能从精索静脉曲张修复术中获益最大仍是一个有争议的问题。本研究的目的是评估某些干预前精子参数是否可预测精索静脉曲张修复术的成功，成功定义为总活动精子数（TMSC）增加。我们对111例接受精索静脉曲张修复术的精索静脉曲张患者进行了回顾性研究，这些患者来自意大利卡塔尼亚大学内分泌、代谢疾病与营养科以及土耳其塞尔丘克大学医学院泌尿外科。预测分析通过使用Brain Project进行，这是一种创新工具，可对将研究对象与各种可用参数相关联的数学表达式进行全面且完全无偏的搜索。当TMSC增加至少达到干预前值的50%时，精索静脉曲张修复术被认为是成功的。对于干预前TMSC低于5×10⁶的患者，当增加超过50%且绝对TMSC值>5×10⁶时，改善被认为具有临床意义。仅从干预前的TMSC来看，我们发现了一个模型，该模型预测似乎从精索静脉曲张修复术中获益不大的患者，其敏感性为50.0%，特异性为81.8%。精索静脉曲张分级和血清卵泡刺激素（FSH）水平未发挥预测作用，但应注意，本研究纳入的所有患者均为中重度精索静脉曲张且FSH水平正常。总之，对于中重度精索静脉曲张且FSH水平正常的患者，干预前TMSC可预测精索静脉曲张修复术在TMSC改善方面的成功。
