Preoperative sonographic and Doppler parameters predictors of semen analysis improvement after unilateral varicocelectomy

Objective

To assess the sonographic and Doppler parameters predicting varicocelectomy outcome.

Methods

This study included 86 infertile patients with abnormal semen analysis. All patients had preoperative ultrasound and color Doppler to calculate testicular volume, pampiniform vein caliber and duration of reflux in the dilated veins during sustained valsalva maneuver. The patients underwent unilateral varicocelectomy and had semen analysis 6 months after operation, improvement index of the semen analysis was calculated.

Results

The patients were classified into 2 groups: Group 1: 58 patients with normal-sized testes, and group 2 included 28 patients with subnormal testes (8–12 cm³), in the first group, the patients with improvement index >0.5 were 26 (44.8%), the group with subnormal testicular volume showed improvement in 5 patients (17.8%) , the difference between the two groups was statistically significant <0.05. There was a significant positive correlation between the degree of reflux preoperatively and the improvement index (P < 0.001), also there was a positive correlation between the vein diameter and the improvement index (P = 0.03).

Conclusions

The best preoperative sonographic parameters of success of unilateral varicocele repair are the presence of normal-sized testes, high grade reflux, and to lesser degree large vein diameter.