Needle aspiration testicular cytology as diagnostic parameter in the assessment with varicocele

OBJECTIVE: Varicocele is considered the most common cause of male infertility. The pathogenesis of the spermatogenetic impairment in this disease is not completely understood and the seminal patterns of patients with varicocele are different. Testicular fine-needle aspiration cytology (FNAC) in infertile men allows us to obtain many information about the type and the degree of alteration of the seminiferous tubule. MATERIALS AND METHODS: In this study, 200 infertile men with varicocele were evaluated for seminal parameters, FSH, LH and testosterone plasma concentrations. Testicular pattern was analyzed by bilateral FNAC. All patients suffered of infertility for at least two years and varicocele was the sole infertility-related pathology. According to the tubular patterns, we divided the patients into five groups, and we observed that the different tubular alterations could be present in patients with similar FSH levels and similar sperm count. Then, to verify the role of tubular pattern as prognostic factor for the correction of varicocele, we studied 70 men, performing seminal analysis and hormonal evaluation six months after sclerotherapy. RESULTS: We found an increasing in sperm count and in other seminal parameters after the sclerotherapy (motility, normal morphology...) only in patients with maturative alteration at spermatid level. This alteration of spermiogenesis seems to be reversible after sclerotherapy. CONCLUSION: In the light of these results the testicular FNAC gives important prognostic parameters in the selection of patients affected by varicocele for sclerotherapy.