Ultrasonic predictors of improved seminal parameters after bilateral laparoscopic varicocelectomy
The effect of varicocelectomy on semen parameters of varicocele with low-grade reflux and low testicular vein diameter is poorly documented. Our study aimed at determining whether preoperative venous diameter and grade of reflux predict semen parameters improvement after varicocelectomy. We studied 85 patients undergoing bilateral laparoscopic varicocelectomy (BLV). Follow-up was performed at 3 and 6 months after surgery. We surveyed the correlation between semen parameters improvement and testicular vein diameter at the inferior pole of the testis, and the degree of reflux measured by color Doppler ultrasound (CDU). BLV resulted in a statistically significant increase in semen analysis parameters (p = 0.00). There was a correlation between testicular vein diameter and the improvement index in sperm motility (r = 0.31, p = 0.006). There was a significant correlation between the degree of reflux detected by CDU and improvement index in sperm concentration (r = 0.37, p = 0.001). Patients with testicular vein diameter > 2.5 mm and higher grades of reflux detected at the veins at the lower pole of the testis had higher improvement index after BLV. Therefore, we can select the patients with these criteria for BLV.