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Effect of varicocelectomy on patients with unobstructive azoospermia and severe oligospermia.

Ishikawa T, Kondo Y, Yamaguchi K, Sakamoto Y, Fujisawa M

Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. iskwtmmt@med.kobe-u.ac.jp

OBJECTIVES: To assess the treatment outcome and benefits after varicocelectomy in men with unobstructive azoospermia (UOA) and severe oligospermia (SO). PATIENTS AND METHODS: The records were retrospectively evaluated for six patients with UOA and 54 with SO who had microsurgical inguinal varicocele ligation (mean age 33.3 years, SD 5.3). Fifty-one (85%) had a unilateral left-sided procedure (five of six with UOA, 46 of 54 with SO), and nine (15%) had a bilateral procedure. RESULTS: After ligation, spermatogenesis was induced in two of the six men with UOA; the mean (SD) sperm concentration increased from 2.3 (1.6) to 9.2 (12.6) million/mL (P < 0.001), but the sperm motility did not change significantly. Four (7%) of the 54 men with SO achieved paternity, with unassisted pregnancies. CONCLUSIONS: Varicocelectomy resulted in the induction or enhancement of spermatogenesis for several men with UOA or SO; it seems to be a reasonable option in selected patients with UOA or SO.

Published 4 January 2008 in BJU Int, 101(2): 216-8.
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