Varicocele Surgery: Three Years Experience

Despite available treatments like varicocelectomy, a standard therapy remains controversial. Varicocele repair has shown promise in improving sperm parameters, but further research is needed, especially in nonobstructive azoospermia cases. Techniques such as microscopic testicular sperm extraction and intracytoplasmic sperm injection have shown some success in achieving pregnancies. Objective: To articulate our hands-on experience and understanding pertaining to varicocele. Methods: This study included patients who presented to our clinic due to varicocele and underwent surgical procedures between November 2020 and January 2023. Results: This research involved 26 varicocele patients, primarily age rage was 27.5 years old. The majority (85%) had varicocele on the left side, and 15% had bilateral varicocele. The mean vein diameter was 3.58mm and 2.6mm for the left side and bilateral cases respectively, with a general average of 3.45mm. Analysis of sperm count, motility, and morphology reflected an average of 32.6 million/ml, 23.2%, and 5.23%, respectively. An average of 4.45 veins was ligated during surgery, with a slight variance based on the side. One patient lost approximately 85% of the testicular blood supply due to a complication during surgery, leading to testicle hardening without atrophy. Two patients experienced recurrence (7.6% recurrence rate). Negative and positive correlations were found between the number of ligated veins and preoperative sperm count (p=0.043, r=-0.408), and vein diameter and preoperative sperm morphology (p=0.004, r=0.544), respectively. Conclusions: Despite the limitations, our study provides valuable insights into the relationship between varicocele severity and sperm parameters.