92 / 238
92
29
th
CONGRESS OF THE ESPU
MATERIAL AND METHODS
Paired data was prospectively collected from a single institution from 2009 to 2017. All patients aged
12 to 17 years post-pubertal with visible or palpable varicoceles and testicular asymmetry (>20 %)
were eligible. Patients produced semen samples by masturbation before and 6 months following
varicocele surgery. Outcomes were sperm concentration and forward motility. Data is expressed
as mean (standard deviation). Paired t test was used to compare pre and post-surgery sperm
parameters.
RESULTS
28 patients underwent surgery for testicular symmetry, 13 underwent laparoscopic selective vein
ligation and 15 underwent antegrade sclerotherapy. 9 of these patients produced paired sperm data
(before and 6 months after surgery) and were eligible for inclusion. 7 had visible varicoceles and
2 had palpable varicoceles. All had spontaneous venous reflux on Doppler examination pre-op and
all were successfully treated.
Pre-op
Post-op
P value
Age
(years)
14.4 (1.3)
16.2 (1.6)
Abstinence interval (days)
4.4 (1.8)
4.2 (2.2)
0.8
Concentration (millions/ml)
7.2 (10.1)
30.5 (31.3)
0.01*
Forward motility (%)
26.1 (22.7)
48.1 (21.5)
0.01*
*p<0.05
Pre-op all 9 patients had abnormal sperm parameters (either concentration <15 millions per ml or
forward motility <32 %). Post-op 4 out of 9 patients had normal sperm parameters. The remaining
5 patients had improved concentration and forward motility post-op.
CONCLUSIONS
Varicocele surgery in adolescents with testicular asymmetry significantly improves sperm param-
eters and in 44 % restores them to normal.
15:07–15:15
Discussion