Predictive factors of better improvement in semen quality after sclerotization of varicocele: preliminary report

Summary Introduction. Controversial data on effectiveness of varicocele correction are available, and still clear predictive factors of better semen quality improve- ment are lacking. To determine whether age of patients, clinical classification and colorDoppler classification are related to a different semen quality im- provement after sclerotization of varicocele. Material and methods. 113 patients with left unilateral varicocele were se- lected between 2002 and 2007, as they met the criteria of low sperm density, no endocrinological failures and no recidivation of varicocele after correction. All patients underwent retrograde percutaneous sclerotization of varicocele or, if not possible, anterograde sclerotization. All patients underwent physical examination, FSH measurement, seminal analysis (sperm density, motility and percent of regular-morphology sperms), scrotal ultrasonography and colorDoppler scrotal evaluation. At least 3 months postoperative, they were assessed with the same protocol. Results. Mean age was 32,2 yr. We found improvement in seminal param- eters among the whole population (sperm density: +92,4% percent of mobile cells: +42,2%, percent of normal cells: +21,7%; p 39: 20,3; p > 0,2). We found no significance in differences among semen quality improvement of patients with subclinical vs. clinical varicocele. Significant evidence of higher improvement in semen quality parameters have been found among patients with basal renal reflow at preoperative evalua- tion vs. patients without basal renal reflow (sperm density: +139% vs. +53%, p = 0,006). Conclusions. Treatment of varicocele results in improvement of seminal quality among all patients. Age is not related to a different outcome. The presence of a basal renal preoperative reflow is associated with higher im- provement in semen quality parameters after sclerotization.