Beneficial Effects of Microsurgical Varicocelectomy on Semen Parameters in Patients Who Underwent Surgery for Causes Other Than Infertility

ObjectivesTo evaluate whether clinical varicoceles are associated with abnormal semen parameters and whether varicocelectomy could improve the parameters in patients with causes other than infertility.MethodsA total of 268 adult men with clinical varicocele underwent microsurgical varicocelectomy resulting from causes other than infertility. A retrospective analysis of total sperm count, total motile sperm count, sperm concentration, motility, and morphology were performed.ResultsOf 268 patients, at least 1 abnormal parameter (concentration, motility, or morphology) was found on preoperative semen analysis in 169 (63.1%) patients for whom 121 postoperative analyses were available. Abnormal sperm concentration was observed in 49 (40.5%) patients, motility in 112 (92.6%) patients, and morphology in 82 (67.8%) patients. Total sperm count, total motile sperm count, sperm concentration, and motility showed statistically significant improvement after microsurgical varicocelectomy, however, sperm morphology did not. Subgroup analysis of patients with oligospermia, asthenospermia, or teratospermia showed significant improvement in all semen parameters after varicocelectomy. The highest improvement rate was observed in sperm concentration of patients with oligospermia when a greater than 20% change in preoperative value was defined as improvement or deterioration in semen parameters. Overall, 92 (76.0%) patients showed improvement in at least 1 semen parameter.ConclusionsThe majority of varicocele patients with causes other than infertility had abnormal semen parameters, and most semen parameters showed significant improvement after microsurgical varicocelectomy. Therefore, regardless of the chief complaint, semen analysis should be performed in men with clinical varicocele.