Predictive Value of Varicocele Grade and Histopathology in Simultaneous Varicocelectomy and Sperm Retrieval in Non-Obstructive Azoospermia: A Retrospective Cohort Study
2024

Varicocele Repair and Sperm Recovery in Men with Azoospermia

Sample size: 78 publication 10 minutes Evidence: moderate

Author Information

Author(s): Kaltsas Aris, Dimitriadis Fotios, Chrisofos Michael, Sofikitis Nikolaos, Zachariou Athanasios

Primary Institution: Department of Urology, University of Ioannina

Hypothesis

Microsurgical varicocelectomy can improve sperm recovery rates in men with non-obstructive azoospermia, influenced by varicocele grade and histopathology.

Conclusion

Microsurgical varicocelectomy can induce spermatogenesis in a significant proportion of men with non-obstructive azoospermia, especially those with higher-grade varicoceles and favorable histopathological patterns.

Supporting Evidence

  • At the 12-month follow-up, spermatozoa were detected in 33.3% of patients.
  • Patients with Grade II varicoceles had the highest sperm return rate of 45.2%.
  • Histopathological findings showed that patients with hypospermatogenesis had an 84.8% sperm retrieval rate.

Takeaway

This study shows that fixing varicoceles can help some men with no sperm in their semen to start producing sperm again, especially if their varicocele is more severe.

Methodology

A retrospective cohort study of 78 men diagnosed with non-obstructive azoospermia and clinical varicocele who underwent microsurgical varicocelectomy with testicular biopsy.

Potential Biases

Potential observer bias in histopathological evaluations due to a single pathologist's analysis.

Limitations

The study's retrospective design may introduce selection bias, and the small sample size limits generalizability.

Participant Demographics

Mean age of participants was 33.9 years, all had left-sided varicoceles, with 21.8% having bilateral varicoceles.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI: 1.48–23.28 for Grade II vs. Grade I

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/medicina60122056

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