Reproductive function in males with recurrent varicocele
Objective. To assess the male reproductive potential in recurrent varicocele.Gamidov S.I., Shatylko T.V., Bitsoev T.B., Gasanov N.G., Mammaev R.U.
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.
Keywords
recurrent varicocele
infertility
varicocelectomy
spermogram
References
- Гамидов С.И., Павловичев А.А., Андранович С.В., Тажетдинов О.Х. Хирургическое лечение варикоцеле у мужчин с бесплодием. Фарматека. 2010; 18-19: 44-8. [Hamidov S., Pavlovichev A., Andranovach S., Tazhetdinov O. Surgical treatment of varicocele in infertile men. Farmateka. 2010; (18-19): 44-8. (in Russian).]
- Kroese A.C., de Lange N.M., Collins J., Evers J.L. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst. Rev. 2012; (10): CD000479. https://dx.doi.org/10.1002/14651858.CD000479.pub5.
- Baazeem A., Belzile E., Ciampi A., Dohle G., Jarvi K., Salonia A. et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur. Urol. 2011; 60(4):796-808. https://dx.doi.org/10.1016/j.eururo.2011.06.018.
- Гамидов С.И., Попков В.М., Шатылко Т.В., Попова А.Ю., Королев А.Ю., Овчинников Р.И., Гасанов Н.Г. Место медикаментозной терапии в лечении мужчин с варикоцеле. Урология. 2018; 5: 114-21. [Gamidov S.I., Popkov V.M., Shatylko T.V., Popova A.Yu., Korolev A.Yu., Ovchinnikov R.I., Gasanov N.G. The role of drug therapy in the management of varicocele. Urologiia. 2018; (5): 114-21. (in Russian).]
- Rotker K., Sigman M. Recurrent varicocele. Asian J. Androl. 2016; 18(2): 229-33. https://dx.doi.org/10.4103/1008-682X.171578.
- Мухиддинов Н.Д., Маликов М.Х., Рашидов Ф.Ш., Одинаев Х.С., Абдуллоев З.Р. Причины рецидива варикоцеле. Вестник Авиценны. 2017; 19(3): 379-81. [Mukhiddinov N.D., Malikov M.Kh.,i Rashidov F.Sh., Odinaev H.S., Abdulloev Z.R. Varicocele relapse causes. Avicenna Bulletin/Vestnik Avitsenny. 2017; 19(3): 379-81. (in Russian).]
- Cayan S., Kadioglu T.C., Tefekli A., Kadioglu A., Tellaloglu S. Comparison of results and complications of high ligation surgery and microsurgical high inguinal varicocelectomy in the treatment of varicocele. Urology. 2000; 55(5): 750-4. https://dx.doi.org/10.1016/s0090-4295(99)00603-2.
- Watanabe M., Nagai A., Kusumi N., Tsuboi H., Nasu Y., Kumon H. Minimal invasiveness and effectivity of subinguinal microscopic varicocelectomy: a comparative study with retroperitoneal high and laparoscopic approaches. Int. J. Urol. 2005; 12(10): 892-8. https://dx.doi.org/10.1111/j.1442-2042.2005.01142.x.
- Ghanem H., Anis T., El-Nashar A., Shamloul R. Subinguinal microvaricocelectomy versus retroperitoneal varicocelectomy: comparative study of complications and surgical outcome. Urology. 2004; 64(5): 1005-9. https://dx.doi.org/10.1016/j.urology.2004.06.060.
- Yavetz H., Levy R., Papo J., Yogev L., Paz G., Jaffa A.J., Homonnai Z.T. Efficacy of varicocele embolization versus ligation of the left internal spermatic vein for improvement of sperm quality. Int. J. Androl. 1992; 15(4): 338-44. https://dx.doi.org/10.1111/j.1365-2605.1992.tb01133.x.
- Shiraishi K., Oka S., Ito H., Matsuyama H. Comparison of the results and complications of retroperitoneal, microsurgical subinguinal, and high inguinal approaches in the treatment of varicoceles. J. Androl. 2012; 33(6): 1387-93. https://dx.doi.org/10.2164/jandrol.112.016444.
- Al-Kandari A.M., Shabaan H., Ibrahim H.M., Elshebiny Y.H., Shokeir A.A. Comparison of outcomes of different varicocelectomy techniques: open inguinal, laparoscopic, and subinguinal microscopic varicocelectomy: a randomized clinical trial. Urology. 2007; 69(3): 417-20. https://dx.doi.org/10.1016/j.urology.2007.01.057.
- Al-Said S., Al-Naimi A., Al-Ansari A., Younis N., Shamsodini A., As K., Shokeir A.A. Varicocelectomy for male infertility: a comparative study of open, laparoscopic and microsurgical approaches. J. Urol. 2008; 180(1): 266-70. https://dx.doi.org/10.1016/j.juro.2008.03.050.
- Abdel-Maguid A.F., Othman I. Microsurgical and nonmagnified subinguinal varicocelectomy for infertile men: a comparative study. Fertil. Steril. 2010; 94(7): 2600-3. https://dx.doi.org/10.1016/j.fertnstert.2010.03.063.
- Mehan D.J., Andrus C.H., Parra R.O. Laparoscopic internal spermatic vein ligation: report of a new technique. Fertil. Steril. 1992; 58(6): 1263-6. https://dx.doi.org/10.1016/s0015-0282(16)55585-x.
- Enquist E., Stein B.S., Sigman M. Laparoscopic versus subinguinal varicocelectomy: a comparative study. Fertil. Steril. 1994; 6(6): 1092-6. https://dx.doi.org/10.1016/s0015-0282(16)56762-4.
- Nabi G., Asterlings S., Greene D.R., Marsh R.L. Percutaneous embolization of varicoceles: outcomes and correlation of semen improvement with pregnancy. Urology. 2004; 63(2): 359-63. https://dx.doi.org/10.1016/j.urology.2003.09.026.
- Li L., Zeng X.Q., Li Y.H. Safety and effectiveness of transcatheter foam sclerotherapy for testicular varicocele with a fluoroscopic tracing technique. J. Vasc. Interv. Radiol. 2010; 21(6): 824-8. https://dx.doi.org/10.1016/j.jvir.2010.02.026.
- Студенникова В.В., Севергина Л.О., Исмаилов М.Т., Коровин И.А., Рапопорт Л.М., Захаров А.И., Петрухина Ю.В. Современный взгляд на патогенез варикоцеле и проблему развития его рецидивов. Урология. 2018; 1:150-4. Studennikova V.V., Severgina L.O., Ismailov M.T., Korovin I.A., Rapoport L.M., Zakharov A.I., Petrukhina Yu.V. Current view on the pathogenesis of varicocele and the problem of its recurrence. Urologiia. 2018; (1): 150-4. (in Russian.).] https://dx.doi.org/10.18565/urology.2018.1.150-154.
- Grober E.D., Chan P.T., Zini A., Goldstein M. Microsurgical treatment of persistent or recurrent varicocele. Fertil. Steril. 2004; 82(3): 718-22. https://dx.doi.org/10.1016/j.fertnstert.2004.03.028.
- Madjar S., Moskovitz B., Issaq E., Weinberger M., Nativ O. Low inguinal approach for correction of recurrent varicocele. Int. Urol. Nephrol. 1998; 30(1): 69-73. https://dx.doi.org/10.1007/bf02550281.
- Chawla A., Kulkarni G., Kamal K., Zini A. Microsurgical varicocelectomy for recurrent or persistent varicoceles associated with orchalgia. Urology. 2005; 66(5): 1072-4. https://dx.doi.org/10.1016/j.urology.2005.05.052.
- Mazzoni G., Minucci S., Gentile V. Recurrent varicocele: role of antegrade sclerotherapy as first choice treatment. Eur. Urol. 2002; 41(6): 614-8. https://dx.doi.org/10.1016/s0302-2838(02)00128-8.
- Kim J., Shin J.H., Yoon H.K., Ko G.Y., Gwon D.I., Kim E.Y., Sung K.B. Persistent or recurrent varicocoele after failed varicocoelectomy: outcome in patients treated using percutaneous transcatheter embolization. Clin. Radiol. 2012; 67(4): 359-65. https://dx.doi.10.1016/j.crad.2011.10.007.
Received 29.01.2020
Accepted 07.02.2020
About the Authors
Safar I. Gamidov, MD; Head, Department of Andrology and Urology, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology; Professor, Department of Obstetrics, Gynecology, and Perinatology, Institute of Postgraduate Education, I.M. Sechenov First Moscow State Medical University.Tel.: +7 (495) 5314444. E-mail: safargamidov@yandex.ru.
Address: 4, Oparin St., Moscow 117997.
Taras V. Shatylko, Cand. Med. Sci., Urologist, Department of Andrology and Urology, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology. Tel.: +7 (927) 6204925. E-mail: dialectic.law@gmail.com.
Address: 4, Oparin St., Moscow 117997.
Timur B. Bitsoev, Postgraduate Student, Department of Obstetrics, Gynecology, and Perinatology, Institute of Postgraduate Education, I.M. Sechenov First Moscow State Medical University. Tel.: +7 (926) 7278865. E-mail: 6646362@mail.ru.
Address: 2, Bolshaya Pirogovskaya St., Build. 4, Moscow 119991, Russia.
Natig V. Gasanov, Urologist, Department of Andrology and Urology, V.I. Kulakov National Medical Research Center of Obstetrics,
Gynecology, and Perinatology. Tel.: +7 (495) 5314444. E-mail: natiqhasan@gmail.com.
Address: 4, Oparin St., Moscow 117997.
Ramazan U. Mammaev, Fifth-Year Student, Faculty of the International School “Medicine of the Future”, I.M. Sechenov
First Moscow State Medical University. Tel.: +7 (985) 4807118. E-mail: ramazan.mammaev@outlook.com.
Address: 2, Bolshaya Pirogovskaya St., Build. 4, Moscow, 119991, Russia.
For citation: Gamidov S.I., Shatylko T.V., Bitsoev T.B., Gasanov N.G., Mammaev R.U. Reproductive function in males with recurrent varicocele. Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020;4: 176-181. (In Russian).
https://dx.doi.org/10.18565/aig.2020.4.176-181
Similar Articles
