Purpose: A continuous spermatic venous reflux (SVR) at colour Doppler ultrasound (CDU) is an evidence for varicocele, a frequent correlate for male subfertility. We explored whether SVR after left varicocele repair is predictive for changes in semen quality in subfertile men. Methods: Blood hormones (FSH, LH, and total testosterone) and scrotal CDU were obtained in subfertile patients with left grade II or grade III varicocele on physical evaluation and a poor sperm quality. Semen analysis and CDU were re-evaluated 6Â months after a retrograde internal spermatic vein scleroembolisation. Results: The retrospective study included 100 men with a baseline SVR >3Â cm/s; 60 men showed a disappearance (group 1) and 40 men (group 2) showed a reduced SVR after varicocele repair. Total motile sperm count (TMC) was markedly increased after treatment (pÂ <Â 0.0001; FÂ =Â 35.79) and the increase was more relevant in group 1 compared to group 2 (pÂ =Â 0.04; FÂ =Â 4.20). TMC and left SVR values after varicocele repair were negatively correlated (RÂ =Â â0.218; pÂ =Â 0.035). Multivariate analysis showed that adjusted SVR after repair negatively predicted TMC change (TMC after repair minus baseline TMC) (ÃÂ =Â â2.56; pÂ =Â 0.022). Disappearance of a continuous left SVR at CDU after varicocele repair was associated to a better improvement of semen parameters in subfertile men. Conclusion: Recording of a continuous left spermatic vein reflux is an objective method to assess a successful varicocele repair aimed to improve sperm parameters in subfertile men.
|Titolo:||Determination of spermatic vein reflux after varicocele repair helps to define the efficacy of treatment in improving sperm parameters of subfertile men|
|Autori interni:||NECOZIONE, STEFANO|
|Data di pubblicazione:||2017|
|Rivista:||JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION|
|Appare nelle tipologie:||1.1 Articolo in rivista|