Bilaterality of varicocele: The overlooked culprit in male infertility. Case series study.

Autor: Almekaty KM; Urology Department, Tanta University, Tanta. dr.khaledhafez@med.tanta.edu.eg., Elsharkawy AM; Radiology Department, Tanta University, Tanta. ahmed.elsharkawy84@gmail.com., Zahran MH; Mansoura Urology and nephrology centre, Mansoura University, Mansoura. zahranmha@yahoo.com., Ragab MM; Urology Department, Tanta University, Tanta. mmregy@yahoo.com., Rashed AS; Urology Department, 6th of October University, Cairo. aymanrashed@msn.com., Soliman MM; Obstetrics and Gynecology Department, Cairo University, Cairo. dr_mahmoudsoliman@yahoo.com., Salem KA; Urology Department, Tanta University, Tanta. khsalemmd@gmail.com., Ghaith AF; Urology Department, Tanta University, Tanta. dr_ahmedfayez@yahoo.com.
Jazyk: angličtina
Zdroj: Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica [Arch Ital Urol Androl] 2023 Sep 12; Vol. 95 (3), pp. 11580. Date of Electronic Publication: 2023 Sep 12.
DOI: 10.4081/aiua.2023.11580
Abstrakt: Objectives: Varicocele is the most common correctable cause of male infertility that always has been a debatable subject as regards how it affects fertility and the best way to treat it. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome. This study aimed to objectively assess varicocele bilaterality in infertile men aiming to improve treatment outcome in this cohort of patients.
Methods: This prospective study was conducted between January 2019 and January 2022 including infertile males with varicoceles. Assessment of missed concomitant contralateral varicocele done pre-operatively by Color Doppler Ultrasound and intraoperatively by intraoperative Doppler device and measurement of maximal vein diameter of contralateral side.
Results: A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the study population, bilaterality of varicocele was found to be as high as 98.5% (324/329). Repeat CDUS strongly correlated with the intraoperative measured varicocele diameter (r = 0.9, p < 0.001). Moreover, sperm parameters showed significant improvement 3 and 6 months post varicocelectomy. Normal pregnancy after 1 year of surgery occurred in 118 cases (35.9%).
Conclusions: Varicocele bilaterality in infertile men is underreported. Thorough assessment by expert radiologists and andrologists is of paramount importance not to miss significant pathology or hazard treatment outcome.
Databáze: MEDLINE
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