La varicocèle de l’adulte: aspects anatomo-cliniques et resultats therapeutiques au service d’urologie-andrologie du CHU de Conakry, Guinee

Autor: M Barry, O R Bah, T.M.O. Diallo, D. Kanté, Mamadou Diawo Bah, D. Cissé, A. B. Diallo, I Bah, M B Diallo
Rok vydání: 2015
Předmět:
Zdroj: African Journal of Urology, Vol 21, Iss 2, Pp 137-141 (2015)
African Journal of Urology; Vol 21, No 2 (2015); 137–141
ISSN: 1110-5704
DOI: 10.1016/j.afju.2015.02.002
Popis: Objectif: Decrire les aspects anatomo-cliniques et evaluer les resultats therapeutiques de la varicocele au service d’urologie-andrologie du CHU de Conakry. Patients et Methode : Il s’agit d’une etude prospective de type descriptif portant sur un echantillonnage exhaustif de 119 cas colliges dans le service d’Urologie-Andrologie du CHU de Conakry durant une periode d’un an. Sur le plan clinique les varicoceles ont ete classees en 4 grades selon Dubin et Amelar. Tous les patients avaient beneficie d’au moins un spermogramme en pre et post operatoire. Resultats : L’âge moyen des patients etait de 38 ans avec des extremes de 22 et 53 ans. La varicocele etait decouverte dans 80,7% (n = 96) des cas au cours d’une consultation pour infertilite conjugale. La varicocele etait gauche dans 84,9% (n = 101) des cas et bilaterale dans 15,1% (n= 18) des cas. Le spermogramme preoperatoire etait normal dans 5% des cas et l’oligo-astheno-teratozoospermie avec 46,2% (n = 55) des cas etait l’anomalie la plus retrouvee. Tous les patients ont beneficie d’une cure chirurgicale selon la technique d’Ivanissevitch. Apres un suivi moyen de 17 mois pour 113 patients, une amelioration notable de la qualite du sperme a ete notee chez 67 patients avec une normalization du spermogramme chez 33 d’entre eux. Par contre aucune amelioration n’a ete notee chez 6 des 8 patients azoospermes. Quarante-deux grossesses spontanees soit 35.3% ont ete enregistrees chez les conjointes des patients durant le suivi. Conclusion : La varicocele est une pathologie frequente dans notre pratique quotidienne; l’infertilite du couple en est la forme de decouverte la plus frequente. Le profil spermatique est celui d’une oligoasthenoteratozoospermie. La cure chirurgicale ameliore de fac¸on significative la fertilite des patients hypofertiles. MOTS CLES: Varicocele; spermogramme; chirurgie; fertilite Adult varicocele: anatomical, clinical aspects and therapeutic results in the service of urology-andrology at Conakry teaching hospital, Guinea Objective : To describe the clinical aspects of varicocele and to evaluate the outcome of its treatment at the Department of Urology and Andrology of Conakry University Hospital, Republic of Guinea. Patients and Methods : This prospective study included 119 patients with varicocele operated on at the Department of Urology and Andrology of Conakry University Hospital over a one-year period. Clinically, the varicoceles were classified into four grades according to the classification of Dubin and Amelar. All patients received at least one semen analysis pre- and postoperatively. Results : The mean age of the patients was 38 (range 22–53) years. In 80.7% (n = 96) of the cases the varicocele was detected in the course of an infertility consultation. The varicocele was located on the left side in 84.9% (n = 101) of the cases, while it was bilateral in 15.1% (n = 18). Preoperative semen analysis was normal in 5% of the cases. Oligo-astheno-teratozoospermia seen in 46.2% (n = 55) of the patients was the most frequently found anomaly. All patients underwent surgical treatment using the Ivanissevich procedure. After a mean follow up of 17 months conducted on 113 patients, significant improvement in sperm quality was observed in 67 patients with normalization of the sperm count in 33 of them. However, no improvement was noted in 6 out of 8 patients who had presented with azoospermia. Forty-two (35.3%) spontaneous pregnancies were recorded during the follow-up period. Conclusion: Varicocele is a common condition in our daily practice. It is most commonly detected in the course of consultation for infertility. The spermatic profile is that of oligo-astheno-teratozoospermia. Surgical treatment significantly improves the hypofertile patient’s fertility. KEYWORDS: varicocele; semen analysis; surgery; fertility
Databáze: OpenAIRE
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