Effects of varicocele repair in adults on ultrasonographically determined testicular volume and on semen profile.

OBJECTIVES

We determined the effect of varicocele repair on testicular volume according to scrotal ultrasonography, reported to provide the best approximation of actual testicular volume.

METHODS

Forty-four men with left varicocele (mean age +/- standard deviation, 33.4 +/- 5.4 years) underwent varicocele repair. We performed both scrotal ultrasonography with color Doppler imaging and semen analysis before and after varicocele repair. Among these patients, 19 had a clinical left varicocele, 22 had clinical left and subclinical right varicoceles, and 3 had clinical left and right varicoceles. We calculated testicular volumes using the formula: Length x Width x Height x 0.71.

RESULTS

For all 44 patients, mean left and total testicular volume improved significantly after varicocele repair (increases of 1.5 and 2.4 mL, respectively) as did semen profile data such as sperm per unit volume and percentage of motile sperm. In the 19 men with a clinical left varicocele, mean left testicular volume increased significantly (by 1.5 mL) after left varicocele repair, in association with increases in sperm per unit volume and motility percentage. In the 25 men with clinical left varicocele plus a subclinical or clinical right varicocele, mean left and total testicular volume improved significantly after repair of right and left varicoceles (increases of 1.5 and 2.7 mL, respectively). However, right testicular volume showed no significant increase in any patient group.

CONCLUSIONS

Varicocele repair in adults with a clinical left varicocele increased left testicular volume and improved semen profiles.