The significance of microsurgical varicocelectomy in the treatment of subclinical varicocele.
OBJECTIVE
To assess the improvement of seminal characteristics and pregnancy rates after microsurgical varicocelectomy in men with subclinical varicocele.


METHODS
Retrospective study.


METHODS
University infertility clinic.


METHODS
One hundred forty-three patients with a subclinical left-sided varicocele.


METHODS
Patients who agreed to microsurgical varicocelectomy (n = 25, surgery group), medical treatment with L-carnitine (n = 93 drug group), and those who did not agree to any treatment (n = 25, observation group) were enrolled.


METHODS
Semen characteristics were reevaluated twice 6 months after treatment. The natural pregnancy rates were estimated by telephone interview between 1 and 2 years after treatment.


RESULTS
In the surgery group, sperm counts improved significantly after microsurgical varicocelectomy. In the drug group, however, sperm parameters did not significantly improve after treatment. Natural pregnancy rates were 60.0% in the surgery group, 34.5% in the drug group, and 18.7% in the observation group. The natural pregnancy rate of the surgery group was higher than the other groups, and there were statistically significant differences among the three groups.


CONCLUSIONS
Surgical treatment is the best option for management of subclinical varicocele.
Seo
Ju Tae
JT
Department of Urology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, South Korea. jtandro@cgh.co.kr
Kim
Kyung Tae
KT
Moon
Min Hoan
MH
Kim
Won Tae
WT
D000328:Adult; D002331:Carnitine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055101:Semen Analysis; D013085:Spermatic Cord / Q000293:injuries; D013737:Testis / Q000473:pathology; D013519:Urogenital Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D014646:Varicocele / Q000188:drug therapy / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery*
D002331:Carnitine