Role of renospermatic basal reflow and age on semen quality improvement after sclerotization of varicocele.
OBJECTIVE
To determine the relationship between renospermatic basal reflow at color Doppler ultrasound (CDU) evaluation and the improvement in seminal quality after sclerotization of varicocele, and the role of patients' age. No clear predictive factors are available for selecting patients who will show a better seminal improvement after varicocele correction.


METHODS
Between 2002 and 2008 we selected 113 patients with left unilateral varicocele, meeting the criteria of low sperm density, no endocrinological failures and no varicocele recidivating. Varicocele correction was performed using the retrograde sclerotization technique or, if not possible, the anterograde one. Patients underwent a physical examination, follicle-stimulating hormone assessment, sperm analysis (density, motility, and morphologic analysis), scrotal ultrasound, and CDU evaluation. Patients were divided into 5 groups using the CDU classification (Sarteschi). Three months postoperatively, they were assessed with the same protocol. Mean age was 32.2 years.


RESULTS
We found improvement in seminal quality among the entire population. We found no significance in differences among semen quality improvement in patients of different ages. Patients with basal renospermatic reflow at preoperative CDU evaluation (groups 3, 4, and 5) showed a better improvement in sperm density (+139%) than patients with no basal reflow (groups 1 and 2; +61%).


CONCLUSIONS
The presence of a basal reflow at preoperative CDU is a strong predictive factor of a better seminal quality improvement after varicocele correction. On the contrary, patient's age showed no significant relationship.
Department of Urology, University of Trieste, Trieste, Italy. gioliguori@libero.it
Giovanni
G
Liguori
Giangiacomo
G
Ollandini
Giorgio
G
Pomara
Antonio
A
Amodeo
Michele
M
Bertolotto
Giorgio
G
Mazzon
Bernardino
B
de Concilio
Stefano
S
Bucci
Ignazio
I
Gattuccio
Paolo
P
Turchi
Emanuele
E
Belgrano
Carlo
C
Trombetta
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012039:Regional Blood Flow; D015911:Sclerotherapy; D055101:Semen Analysis; D014646:Varicocele / Q000503:physiopathology* / Q000628:therapy*; D055815:Young Adult