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Choi, Kim, Paick, and Kim: Factors Related to Improvement or Normalization of Semen Parameters after Microsurgical Subinguinal Varicocelectomy
Original Article
Korean Journal of Urology

Korean Journal of Urology 2009; 50(1): 39-45.

Published online: 31 January 2009

DOI: https://doi.org/10.4111/kju.2009.50.1.39

Factors Related to Improvement or Normalization of Semen Parameters after Microsurgical Subinguinal Varicocelectomy

Woo Suk Choi, Tae Beom Kim1, Jae-Seung Paick, Soo Woong Kim

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

1Department of Urology, Gil Medicine Center, Gachon University of Medicine and Science, Incheon, Korea.

swkim@snu.ac.kr

Received 30 September 2008       Accepted 24 October 2008

Copyright © 2009 The Korean Urological Association

Abstract

Purpose

To determine factors related to improvement or normalization of semen parameters after varicocelectomy, we retrospectively analyzed patients who underwent semen evaluation before and after varicocelectomy.

Materials and Methods

A total of 133 patients undergoing left-sided microsurgical subinguinal varicocelectomy for clinically palpable varicoceles with at least one abnormal semen parameter were included in this study. Preoperative and postoperative semen parameters were analyzed. We defined improvement in semen parameters as a greater than 20% change in preoperative values. Several potential predictors of improvement or normalization of each semen parameter were analyzed by multivariate logistic regression model.

Results

Of 133 patients, 64, 105, and 68 patients had abnormal sperm concentration, motility, and morphology, respectively. Postoperative mean values of each parameter were significantly improved after varicocelectomy. In subgroup analyses of the patients with oligospermia, asthenospermia, or teratospermia, improvement in each parameter (concentration, motility, morphology) was observed in 65.6% (42/64), 71.4% (75/105), and 51.5% (35/68) of the patients, respectively, and normalization of each parameter was observed in 42.2%, 29.5%, and 57.4% of the patients, respectively. Absence of testicular size discrepancy and preoperative sperm concentration were independent predictive factors for normalization of the sperm concentration. For improvement of sperm motility, a significant correlation was found with grade of varicocele. Meanwhile, for normalization of sperm motility, significant correlations were found with age and preoperative sperm motility.

Conclusions

Substantial improvement and normalization in each semen parameter was observed after microsurgical subinguinal varicocelectomy. There were different independent predictive factors for improvement or normalization of each semen parameter.

Keywords: Varicocele, Semen

Figures and Tables

Table 1
Preoperative and postoperative semen parameters in all patients
kju-50-39-i001

Data are expressed as mean±SD (standard deviation). *: statistical analysis by paired t-test

Table 2
Preoperative and postoperative semen parameters in each patient with oligospermia, asthenospermia, or teratospermia
kju-50-39-i002

Data are expressed as mean±SD (standard deviation). *: statistical analysis by paired t-test

Table 3
Patients with improved or normalized semen parameters in each patient with oligospermia, asthenospermia, or teratospermia
kju-50-39-i003
Table 4
Multivariate logistic regression analysis of preoperative predictors for improvement of each semen parameter
kju-50-39-i004

LH: luteinizing hormone, FSH: follicle stimulating hormone, *: statistically significant, p<0.05, †: presence of testicular volume discrepancy, absence of discrepancy as reference, ‡: grade 3 as reference, §: preoperative values

Table 5
Multivariate logistic regression analysis of preoperative predictors for normalization of semen each parameter
kju-50-39-i005

LH: luteinizing hormone, FSH: follicle stimulating hormone, *: statistically significant, p<0.05, †: presence of testicular volume discrepancy, absence of discrepancy as reference, ‡: grade 3 as reference, §: preoperative values

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