EVALUATION OF THE EFFECTIVENESS OF MICROSURGICAL VARICOCELECTOMY IN INFERTILE PATIENTS AT 19-8 HOSPITAL, MINISTRY OF PUBLIC SECURITY
Main Article Content
Abstract
Objectives: Our study aimed to evaluate the effectiveness of microsurgical varicocelectomy in treating male infertility.
Subjects and methods: Data were collected retrospectively from 55 cases of infertile men with clinical varicocele who underwent microsurgical varicocelectomy from December 2021 to December 2025 at the Department of Urology, 19-8 Hospital, Ministry of Public Security. Patients were followed-up 3 months, 6 months and 9 months using semen analysis and hormonal tests.
Results: Mean age of patients was 29.09 ± 2.72 years. Primary infertility was found in 83.6% of patients and the prevalence of secondary infertility was 16.4%. Symptom improvement has been reported in most of patients after the surgical. The sperm analysis revealed statistically significant increases in sperm concentration, progressive sperm motility and normal morphology (p < 0.05). The adjusted testosterone levels increased in hypogonadism group. Reported pregnancy rates was 54.6%, besides the rate of spontaneous pregnacy was 43.6%.
Conclusions: Microsurgical varicocelectomy is an effective procedure for the treatment of varicocele, especially in patients who were infertility. This can improve semen parameters and increase spontaneous pregnacy rates.
Article Details
Keywords
Varicocele, microsurgical varicocelectomy, semen analysis, testosterone, male infertility.
References
[2] Jungwirth A.D, Dohle T, Giwercman G.R et al. Guidelines on male infertility (update 2015). European Association of Urology Guidelines. doi: 10.1016/j.eururo.2012.04.048
3] Mohammed A, Chinegwundoh F. Testicular varicocele: an overview. Urol Int, 2009, 82 (4): 373-379. doi: 10.1159/000218523.
[4] Schlesinger M.H, Wilets I.F, Nagler H.M. Treatment outcome after varicocelectomy: a critical analysis. Urol Clin North Am, 1994, 21 (3): 517-529.
[5] Baazeem A, Belzile E, Ciampi A et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol, 2011, 60 (4): 796-808. doi: 10.1016/j.eururo.2011.06.018.
[6] Abdel-Meguid T. A, Al-Sayyad A, Tayib A et al. Does varicocele repair improve male infertility? An evidence-based perspective from a randomized, controlled trial. Eur Urol, 2011, 59 (3): 455-61. doi: 10.1016/j.eururo.2010.12.008.
[7] Nguyễn Hoài Bắc. Nghiên cứu ứng dụng phương pháp vi phẫu thắt tĩnh mạch tinh trong điều trị vô sinh nam. Luận án tiến sĩ y học, Trường Đại học Y Hà Nội, 2018.
[8] Shamsa A, Nademi M, Aqaee M et al. Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion. Saudi J Kidney Dis Transpl, 2010, 21 (6): 1100-5.
[9] Medicine Practice Committee of the American Society for Reproductive, Reproduction Society for Male and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril, 2014, 102 (6): 1556-60. doi: 10.1016/j.fertnstert.2014.10.007.
[10] Tiseo B.C, Esteves S.C, Cocuzza M.S. Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men. Asian J Androl, 2016, 18 (2): 239-245. doi: 10.4103/1008-682X.172639.
[11] Cho S.Y, Kim T.B, Ku J.H et al. Beneficial effects of microsurgical varicocelectomy on semen parameters in patients who underwent surgery for causes other than infertility. Urology, 2011, 77 (5): 1107-1110. doi: 10.1016/j.urology.2010.10.011
[12] Damsgaard J, Joensen U.N, Carlsen E et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 healthy young men from six European countries. Eur Urol, 2016, 70 (6): 1019-1029. doi: 10.1016/j.eururo.2016.06.044
[13] Yaman O, Ozdiler E, Anafarta K et al. Effect of microsurgical subinguinal varicocele ligation to treat pain. Urology, 2000, 55 (1): 107-8. doi: 10.1016/s0090-4295(99)00374-x.
[14] Schlegel P.N, Goldstein M. Alternate indications for varicocele repair: non-obstructive azoospermia, pain, androgen deficiency and progressive testicular dysfunction. Fertil Steril, 2011, 96 (6): 1288-93. doi: 10.1016/j.fertnstert.2011.10.033.
[15] Zohdy W, Ghazi S and Arafa M. Impact of varicocelectomy on gonadal and erectile functions in men with hypogonadism and infertility. J Sex Med, 2011, 8 (3): 885-93. doi: 10.1111/j.1743-6109.2010.01974.x.
[16] Medicine Practice Committee of the American Society for Reproductive, Reproduction Society for Male and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril, 2014, 102 (6): 1556-60. doi: 10.1016/j.fertnstert.2014.10.007