Value of Testicular Shear Wave Dispersion Imaging in Predicting Semen Improvement After Varicocelectomy.

OBJECTIVE

To evaluate the value of testicular viscoelastic parameters in predicting the improvement of semen parameters after varicocelectomy through testicular shear wave dispersion imaging.

METHODS

Each patient completed testicular shear wave dispersion imaging and semen analysis before and three months after varicocelectomy. Logistic regression analysis was used to assess the predictive ability of testicular viscoelasticity and ultrasonic parameters for postoperative semen parameters improvement. A nomogram was constructed to develop a predictive model for semen parameters improvement after varicocelectomy.

RESULTS

A total of 141 patients were included in the study. Univariate regression analysis showed that bilateral varicocele, internal diameter of the spermatic vein, reflux time, viscosity coefficient, and dispersion slope were predictive factors for postoperative semen parameters improvement. The areas under the ROC curve for reflux time and dispersion slope in predicting postoperative semen parameters improvement were 0.787 and 0.680, respectively. Multivariate regression analysis identified bilateral varicocele (OR: 5.522, CI: 1.415-21.546), reflux time (OR: 1.42, CI: 1.032-1.955), and dispersion slope (OR: 5.16, CI: 1.473-18.076) as significant predictive factors for postoperative semen parameters improvement. A predictive model was established using a nomogram, with an area under the ROC curve of 0.85, demonstrating good calibration (Hosmer-Lemeshow test, p = 0.44) and clinical utility within a threshold probability range of 0.3-0.8.

CONCLUSION

Testicular shear wave dispersion imaging is helpful in predicting semen parameters improvement three months after varicocelectomy. A model combining reflux time and varicocele side has higher predictive ability and practical value.