Assistant Professor of Urology, Kerman University of Medical Sciences and Health Services, Kerman, Iran
This clinical study , carried out from 1996 to 1999, was aimed at assessing the effect of varicoceletomy on the spermogram of patients with subclinical varicocele. A total of 142 patients (mean age 28.1 ± 4.3) with varicocele (63 with subclinical) took part in the study. All individuals were informed and were satisfied to get involve in the study. Two spermograms were recorded one at the beginning and the second one two weeks later in both study patients and control groups. Three to six months after varicoceletomy (high ligation of the internal spermatic vein) two other spermogram with the interval of two weeks were performed on all individuals. The spermogram’s results before and after operation were compared among the individuals of each group. While the results of spermogram of the patients with subclinical varicocele did not showed a significant change after operation , the spermogram of those with clinical varicocele improved significantly after operation. On the other hand bilateral and right varicocele in the patients with subclinical symptom was more prevalent than the other group. Secondary infertility in the patients with subclinical varicocele compare to the other group was much higher.As a result , operation on the patients with subclinical varicocele did not show a significant change compare to the patients who suffered from clinical varicocele (result of spermogram before and after operation). This study guides us to select other methods of treatment rather than surgical operation in subclinical varicocele patients. So we recommend checking other infertility causative factors such as hormonal abnormality , internal urogenital abnormality , and immunological disorders before deciding to perform varicoceletomy in this group.