MANAGEMENT TACTICS FOR INFERTILE MALES WITH VARICOCELE: COMPARATIVE ANALYSIS OF DIFFERENT TREATMENT OPTIONS


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Abstract

Objective. To improve the results of treatment for male infertility in patients with varicocele and to evaluate the efficiency of microsurgical varicocelectomy. Subjects and methods. The Marmar microsurgical subinguinal varicocelectomy (uni- or bilateral) was performed in the authors’ modification in 728 patients with varicocele; medical stimulation of spermatogenesis was carried out in 107 patients for 3-6 months; 56 patients received treatment. Results. After microsurgical varicocelectomy, there were increases in the concentration of sperm from 8.8±7.2 to 23.2±7.9 mln/ml and its active mobility (Grade A) from 7.2±5.4 to 31.2±5.2%, and the proportion of abnormal sperm forms (Kruger morphology) reduced from 95.4±5 to 87.8±8.3%. The patients with azoospermia (n=39), spermatozoa appeared in 46.2% of cases; 52.8% of the patients with complete teratozoospermia (n=36) exhibited morphologically normal sperm postoperatively. Conclusion. Microsurgical varicocelectomy is the most effective and safest treatment option for male infertility in patients with varicocele. This operation may be recommended as the gold standard surgical treatment for varicocele today.

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About the authors

S. I GAMIDOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of the Russian Federation; I.M. Sechenov First Moscow State Medical University, Ministry of Health and Social Development of the Russian Federation

Email: docand@rambler.ru

R. I OVCHINNIKOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of the Russian Federation

Email: r_ovchinnikov@oparina4.ru

A. Yu POPOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of the Russian Federation

Email: a_popova@oparina4.ru. alina-dock@yandex.ru

D. V SHCHERBAKOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of the Russian Federation

Email: d_scherbakov@oparina4.ru. sherb-dm@yandex.ru

R. A TKHAGAPSOYEVA

N.N. Pirogov Russian National Research Medical University, Ministry of Health and Social Development of the Russian Federation

Email: reginamed2@mail.ru

S. Kh IZHBAEV

N.N. Pirogov Russian National Research Medical University, Ministry of Health and Social Development of the Russian Federation

Email: izhbaev-sergei@mail.ru

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