[Varicocele and coincidental abacterial prostato-vesiculitis: negative role about the sperm output].
OBJECTIVE
To evaluate the frequency and the role of a coincidentally expressed abacterial prostato-vesiculitis (PV) on sperm output in patients with left varicocele (Vr).


METHODS
We evaluated 143 selected infertile patients (mean age 27 years, range 21-43), with oligo- and/or astheno- and/or teratozoospermia (OAT) subdivided in two groups. Group A included 76 patients with previous varicocelectomy and persistent OAT. Group B included 67 infertile patients (mean age 26 years, range 21-37) with OAT and not varicocelectomized. Patients with Vr and coincidental didymo-epididymal ultrasound (US) abnormalities were excluded from the study. Following rectal prostato-vesicular ultrasonography, each group was subdivided in two subsets on the basis of the absence (group A: subset Vr-/PV-; and group B: subset Vr+/PV-) or the presence of an abacterial PV (group A: subset Vr-/PV+; group B: subset Vr+/PV+). Particularly, PV was present in 47.4% and 41.8% patients of groups A and B, respectively. This coincidental pathology was ipsilateral with Vr in the 61% of the cases. Semen analysis was performed in all patients.


RESULTS
Patients of group A showed a total sperm number significantly higher than those found in group B. In presence of PV, sperm parameters were not significantly different between matched--subsets (Vr-/PV+ vs. Vr+/PV+). In absence of PV, the sperm density, the total sperm number and the percentage of forward motility from subset with previous varicocelectomy (Vr-/PV) exhibited values significantly higher than those found in the matched--subset (Vr+/PV-).


CONCLUSIONS
Sperm analysis alone performed in patients with left Vr is not a useful prognostic post-varicocelectomy marker. Since following varicocelectomy a lack of sperm response could mask another coincidental pathology, the identification through US scans of a possible PV may be mandatory. On the other hand, an integrated uro-andrological approach, including US scans, allows to enucleate subsets of patients with Vr alone, who will have an expected better sperm response following Vr repair.
Vicari
Enzo
E
Catt. Andrologia, Ist. Medicina Interna & Spec. Internistiche, Università di Catania, Osp. Garibaldi: P.zza S.M. Gesù, 95123 Catania, Italy. acaloger@unict.it
La Vignera
Sandro
S
Tracia
Angelo
A
Cardì
Francesco
F
Donati
Angelo
A
D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000601:surgery; D007249:Inflammation; D007962:Leukocytes; D008297:Male; D011379:Prognosis; D011472:Prostatitis / Q000150:complications* / Q000000981:diagnostic imaging; D012661:Semen / Q000166:cytology / Q000382:microbiology; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000473:pathology*; D013076:Sperm Count; D013081:Sperm Motility; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology; D014463:Ultrasonography; D014646:Varicocele / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery