Longitudinal study of semen quality in adolescents with varicocele: to treat or not?

摘要

OBJECTIVES: To assess the role of varicocelectomy in pediatric patients through a careful semen analysis. METHODS: A total of 214 patients with grade 2 and 3 left idiopathic varicocele were enrolled. Of these 214 patients, 106 (group 1) were treated surgically for testicular hypotrophy, 54 (group 2) were treated surgically with a normal testis, and 54 with a normal testis (group 3) were observed with follow-up visits every 6 months. The spermiogram results for each group were divided into two subgroups: normal, if they met the evaluation criteria and abnormal in the remaining cases. RESULTS: The spermiogram analysis for groups 1 and 2 showed no statistically significant difference in terms of normal and abnormal spermiogram findings (P >0.01). Even though the patients included in group 3 had reported no testicular hypotrophy or pain, the qualitative semen analysis showed the same trend observed in patients affected by varicocele, but the difference was not statistically significant in the variables considered for the other groups (P >0.01). Preservation of the testicular artery in patients with hypotrophy was associated with better results in terms of semen quality. CONCLUSIONS: Testicular hypotrophy remains the most objective indication for surgical treatment of varicocele, and preservation of the testicular artery gives better results in terms of semen quality only in patients affected by testicular hypotrophy.