Does varicocele grade predict the postoperative changes of semen parameters following left inguinal micro-varicocelectomy?

Objective: To evaluate the relationship between preoperative grade and postoperative changes of semen parameters following left inguinal varicocelectomy.

Methods: This study included 44 patients undergoing left microsurgical inguinal varicocelectomy. Internal spermatic veins were classified as large (4 mm or more in diameter), medium (2-4 mm), or small (2 mm or less). Changes in sperm activity, morphology and count were estimated perioperatively. The introperative findings and semen parameters were compared between varicocele groups of grades 2 and 3.

Results: Both sperm motility and count improved significantly postoperatively (from (31.9 ± 16.3)% to (47.3  ± 15.5)%, from (28.1 ± 28.1) × 10/mL to (52.1 ± 74.2) × 10/mL). In varicoceles with grade 2 and 3, significant differences were found in the number of large veins (0.4 ± 0.6 1.2 ± 0.7,  < 0.001) and ultrasonographic maximum diameters of spermatic vein in supine and standing positions (2.3 ± 0.4 cm 2.8 ± 0.6 cm, 3.1 ± 0.7 cm 3.9 ± 0.7 cm,  = 0.001 and 0.001 respectively). However no difference of changes in sperm motility and count was detected ((16.3  ±  13.5)% (14.4  ±  12.6)%, (30.5 ± 84.4) × 10/mL (12.9 ± 20.6) × 10/mL respectively,  = 0.65 and 0.40 respectively).

Conclusion: Preoperative varicocele grade might not predict postoperative semen changes regardless of possible existence of anatomic and ultrasonographic associations.