Reproductive function in males with recurrent varicocele

Objective. To assess the male reproductive potential in recurrent varicocele. Patients and methods. 126 patients aged 23 to 58 years with recurrent varicocele who had been primarily operated on before the age of 18 years or being drafted for military service according to referrals from military registration and enlistment offices (n=59) and in adulthood (n=67) underwent repeat Marmar microsurgical varicocelectomy. Results. By assessing spermogram readings over time, it could be noted that there was significant sperm concentration progress in the patients who had been primarily operated on in both childhood and adulthood. However, there was a considerable effectiveness decrease in the patients who had undergone Palomo surgery in childhood (a sperm concentration increase was observed in 35% of the patients in this group) compared to those who had Ivanissevich’s operation (a sperm concentration increase was seen in 64.1%). The same trend was also noted with direct reproductive results (that is to say, the occurrence of natural pregnancy and the birth of babies), which turned out to be substantially worse in the patients who had primarily undergone Palomo surgery (pregnancy and childbirth occurred in 15% of cases), unlike those who had Ivanissevich’s operation (pregnancy and childbirth occurred in 30.8% of cases). Conclusion. After Ivanissevich’s surgery, the reproductive potential of patients with varicocele recurrences does not depend on the timing of their occurrence. And the natural pregnancy rate after repeat varicocelectomy for a recurrence is statistically lower after Palomo surgery than that after Ivanissevich’s operation.

recurrent varicocele, infertility, varicocelectomy, spermogram