title: Low-grade left varicocele in patients over 30 years old:the effect of spermatic vein ligation on fertility.
abstract: OBJECTIVE
  To evaluate the effect of spermatic vein ligation in patients over 30 years old and with low-grade left varicocele, and thus help to establish whether such patients might benefit from surgery.
  
  
  METHODS
  A randomized study was conducted on 68 infertile patients (30-38 years old) with evidence of sperm abnormalities and who had low-grade varicocele (grade I according to Hirsch), comparing left spermatic vein ligation with no treatment. The outcome was assessed by standard sperm analysis and eventual paternity.
  
  
  RESULTS
  There was no improvement in sperm quality in either of the groups one year after surgery, and no significant difference in paternity.
  
  
  CONCLUSIONS
  Left spermatic vein ligation for low-grade varicocele in patients more than 30 years old cannot be recommended.
authors.affiliation: Department of Urology, Ospedale di Desio, Department of Urology and Biomedical Statistics Unit, Scientific Institute H. San Raffaele, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Grasso
authors.forename: C
authors.initials: C
authors.lastname: Lania
authors.forename: M
authors.initials: M
authors.lastname: Castelli
authors.forename: L
authors.initials: L
authors.lastname: Galli
authors.forename: F
authors.initials: F
authors.lastname: Franzoso
authors.forename: P
authors.initials: P
authors.lastname: Rigatti
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000601:surgery*; D008026:Ligation / Q000379:methods; D008297:Male; D013076:Sperm Count; D013085:Spermatic Cord / Q000098:blood supply*; D013094:Spermatozoa / Q000502:physiology; D014646:Varicocele / Q000150:complications / Q000601:surgery*; D014680:Veins