Varicocele: clinical or surgical treatment?

Varicocele, known as the most common cause of male infertility, has usually been treated surgically and, although successful results have been reported, its therapeutic efficiency has been questioned. Sixty-six infertile men with varicocele were under treatment within the period December, 1971-1981. Thirty-eight underwent surgical correction (varicocelectomy) and twenty-eight received only medical treatment. The spermograms of all the patients reported sperm counts, percentage of general motility, percentage of grade III motile sperm (rapid and directional movements) and percentage of oval forms, before and after the treatment. The results showed that there was an improvement in all the spermogram parameters in both groups. Except for one variable all the others failed to show a significant difference by statistical analysis between both treatments, however, the surgical treatment resulted in higher values when compared to the medical one. Pregnancy rates, while higher for the surgical group, was not statistically different in both groups. The medical treatment showed to be effective in elective cases. Nevertheless, the surgical treatment remains the better choice in the treatment of subfertility associated to varicocele.