title: Role of varicocelectomy in men with nonobstructive azoospermia.
abstract: OBJECTIVE
  To evaluate the benefits of varicocelectomy in men with nonobstructive azoospermia.
  
  
  METHODS
  Retrospective review of effect of prior varicocelectomy on sperm retrieval rates in men with nonobstructive azoospermia. Chart review of men with nonobstructive azoospermia who underwent microsurgical varicocelectomy to determine the effect of the procedure on the need for testicular sperm extraction (TESE).
  
  
  METHODS
  Tertiary, university-based referral center.
  
  
  METHODS
  Men with clinical varicoceles and nonobstructive azoospermia.
  
  
  METHODS
  Microsurgical varicocelectomy, TESE.
  
  
  METHODS
  Return of sperm to the ejaculate and need for TESE after varicocele repair, ability to find sperm using microdissection TESE.
  
  
  RESULTS
  Of 31 men who underwent varicocele repair at one institution for documented nonobstructive azoospermia, 7/31 (22%) had sperm reported on at least one semen analysis postoperatively. However, only 3/31 (9.6%) men after varicocele repair had adequate motile sperm in the ejaculate for ICSI, without TESE. Sperm retrieval rates for men with varicoceles were not affected by a history of prior varicocelectomy.
  
  
  CONCLUSIONS
  Men with clinical varicoceles that are associated with nonobstructive azoospermia will rarely have adequate sperm in the ejaculate after varicocele repair to avoid TESE. A history of prior varicocele repair does not appear to affect the chance of sperm retrieval by TESE for men with clinical varicoceles and nonobstructive azoospermia. The benefits of varicocelectomy in men with nonobstructive azoospermia may be less than previously reported.
authors.affiliation: Department of Urology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York 10021, USA. pnscleg@med.cornell.edu
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schlegel
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kaufmann
mesh_terms: D001706:Biopsy; D002470:Cell Survival; D041322:Chromosomes, Human, Y; D017353:Gene Deletion; D006728:Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008866:Microsurgery; D009845:Oligospermia / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D012661:Semen; D013081:Sperm Motility; D013094:Spermatozoa; D013737:Testis / Q000473:pathology; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications* / Q000601:surgery*
chemical_list: D006728:Hormones