Varicocelectomy in patients with azoospermia.

The results of surgical treatment of 33 men with azoospermia and varicocele are presented. Microscopic examination of a testicular biospy revealed the Sertoli-cells-only syndrome in nine subjects while degenerative changes in the seminiferous tubules of one or both testes were present in another six persons. In 15 cases decreased spermatogenesis was noted in the testis on the side ipsilateral to the varicocele. In the remaining three subjects the biopsy revealed active spermatogenesis but with absent spermiogenesis. In all cases the changes were equal or more advanced on the affected side. Improvement of the spermiogram was noted in 12 men (34%) and spermatozoa appeared in the ejaculate within 2 to 14 months after operation. In three spouses four gestations occurred. Only in one case where the spermiogram showed improvement were the degenerative changes present in both testes. In the remainder of subjects demonstrating improvement in semen quality, irreversible changes were absent in at least one testis.