Testicular volume discrepancy is associated with decreased semen quality in infertile Japanese males with varicoceles.

Purpose: We retrospectively reviewed infertile Japanese males for testicular volume discrepancies (D) and semen parameters to evaluate whether left grade II-III varicoceles (V) cause testicular damage.

Methods: Seventy-seven patients who had idiopathic male infertility and 88 who had V without other causes of infertility were examined. We excluded cases of azoospermia. Testicular volume was measured using a punched-out orchidometer. D was defined as a size difference of at least 3 ml. The frequency of D was compared between the patients with and without V. The semen parameters were reviewed in association with D and V.

Results: The mean left and right testicular volumes were 19.4 and 20.1 ml, respectively ( < 0.001). D with a smaller left testis was more common in V+ cases than in V- cases (26.1 vs. 13.0%, = 0.0351). The sperm count and motility were also significantly lower ( = 0.0213 and = 0.0217, respectively) in the D+ patients with a smaller left testicular volume.

Conclusions: In the patients with V, D was more common than in those without V. The semen parameters were worse if D was present in the patients with V. These results indicated that V could induce testicular atrophy and negatively affect semen quality. Therefore, the ipsilateral reduced testicular volume is considered to be a sign of persisting testicular damage by V.