title: [The treatment of varicocele in the infertile male I: results on semen quality].
abstract: OBJECTIVE
  To evaluate the effect of interventionist treatment of varicocele, either open surgery or endovascular radiological occlusion, on seminal parameters, and to identify which factors are associated with their normalization.
  
  
  METHODS
  Between 1975 and 2000, 631 patients with the diagnosis of idiopathic varicocele were evaluated in our hospital; 238 of them were part of an infertile couple. Among them, finally, 183 underwent studies; they complied with the following criteria: 1) Infertility for more than one year; 2) seminal parameters below normality following WHO criteria (1992); 3) absence of other pathologies or diseases which could explain male infertility; and 4) absence of evident causes of male infertility. 131 patients were treated by radiological occlusion and 26 by conventional surgery. The remaining 26 patients did not undergo the treatment indicated. Two parameters were evaluated on follow-up: 1) achievement of pregnancy (these results will be analyzed in a next article), and 2) normalization of seminal parameters.
  
  
  RESULTS
  48% and 39% of the patients respectively achieved normalization of the number of spermatozoids per ml (=20 million spermatozoids per ml) and spermatic morbidity (=50%). The association between normalization of seminal parameters and age, clinical grade, or type of treatment was not demonstrated. Only baseline degree of severity in the alteration of seminal parameters showed statistically significant differences in the evaluation of semen quality after treatment of varicocele (p = 0.001 and p = 0.002).
  
  
  CONCLUSIONS
  The degree of previous seminal alteration--oligospermia and asthenospermia--was the factor with greatest prognostic value in relation with normalization of seminal parameters.
authors.affiliation: Servicio de Urología, Hospital Doce de Octubre, Madrid, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pamplona Casamayor
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Duarte Ojeda
authors.forename: Roberto
authors.initials: R
authors.lastname: Villar Esnal
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Bolea Laguarta
authors.forename: Javier
authors.initials: J
authors.lastname: de la Cruz Bértolo
authors.forename: Enrique
authors.initials: E
authors.lastname: Alvarez González
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rodríguez Antolin
authors.forename: Oscar
authors.initials: O
authors.lastname: Leiva Galvis
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D012661:Semen; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa; D014646:Varicocele / Q000150:complications / Q000628:therapy*