張雲筑¹、黃奕燊^1,2、黃志賢^{1, 2}、林登龍^1,2、陳光國^1,2

台北榮民總醫院泌尿部¹

國立陽明大學 醫學院 泌尿學科 及 書田泌尿科學研究中心²

Yun-Chu Chang¹, I-shen Huang^{1, 2}, William J.S. Huang^{1, 2},

Alex T. L. Lin^{1, 2}, Kuang-Kuo Chen^{1, 2}

Department of Urology, Taipei Veterans General Hospital¹

Department of Urology, School of Medicine, and Shu-Tien Urological Institute², National Yang Ming University, Taipei, Taiwan

 

Controversial opinion existed between treatment necessities for oligoasthenoteratospermia (OAT) patients with grade I varicocele. The purpose of this study was to evaluate whether right side grade I varicocele should be treated with varicocelectomy.

We retrospectively collected patients who received subinguinal microscopic varicocelectomy due to OAT from April. 2008 to December. 2015. Varicoceles were graded according to guidelines of the World Health Organization. All patients underwent preoperative and postoperative semen analysis. Statistical analysis of the data was performed using the Student t test, Kruskal-Wallis test and Mann-Whitney test, which was considered significant at p <0.05.

A total of 215 patients received subinguinal microscopic varicocelectomy were included in this study. All patients with right side Grade I varicocele presented with bilateral varicocele and among them 5 patients received left side varicocelectomy only ( Group I ) and 6 patients received bilateral varicocelectomy ( Group II ). 40 patients had right side Grade II varicocele and left side varicocele, and all of them received bilateral varicocelectomy (Group III ). Most of their preoperative and postoperative semen parameters including sperm concentration, total count, percent age of motility and normal form showed improvement except concentration in Group I and Group II, count and percent of normal form in Group II. (Table I ) But the improvement all showed no significant difference. Percent of motility showed significant difference ( p = 0.02 ) in the change between Group I and Group III or Group II and Group III ( Table II ).

There was no significant difference of semen parameters between correction of right side Grade I varicocele or not. However, the data neither showed improvement after varicocelectomy in the 2 groups. All semen parameters improved after right side Grade II varicocelectomy and the percent of motility significantly improved compared with remaining the right side Grade I varicocele uncorrected.