title: Prognostic factors for successful varicocelectomy to treat varicocele-associated male infertility.
abstract: The present study identified prognostic factors for successful varicocelectomy for the treatment of varicocele-induced male infertility. All varicoceles were diagnosed and graded by physical examination and ultrasound. Pre- and postoperative analysis of semen specimens measured sperm density, morphology and motility. 'Responder' and 'non-responder' status was determined by semen analyses at 3, 6 and 12 months postoperatively. Varicocele Grades 1, 2 and 3 were found in 16, 36 and 28 patients, respectively; 49 patients (61.3%) were responders based on improved seminograms. Significant postoperative increases were noted in sperm density (from 18.20 ± 14.76 × 10(6) to 32.36 ± 24.81 × 10(6)mL(-1); P<0.001), sperm morphology (from 57.21 ± 17.35% to 62.66 ± 15.18%; P=0.006) and percentage motility (from 29.89 ± 14.71% to 50.92 ± 19.30%; P<0.001). Multivariate logistic regression indicated that age (odds ratio (OR) 0.56; P<0.001) and preoperative sperm density (OR 1.22; P=0.001) had significant unfavourable and favourable associations, respectively, with the likelihood of successful varicocelectomy. Furthermore, a preoperative sperm density of 12 × 10(6)mL(-1) as a cut-off point was able to predict successful varicocelectomy with a sensitivity of 77.6% and specificity of 77.4% (area under the curve=0.85; P<0.001; 95% confidence interval 0.76-0.92). Age and preoperative sperm density are prognostic factors for successful varicocelectomy. The results of the present study may allow clinicians to predict surgical improvement in fertility in patients with varicocele.
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Hsin-Chieh
authors.initials: HC
authors.lastname: Huang
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Shih-Tsung
authors.initials: ST
authors.lastname: Huang
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Yu-Chao
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Po-Chih
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital at Linkou, 5# Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Hsieh
mesh_terms: D019540:Area Under Curve; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology; D013624:Taiwan; D016896:Treatment Outcome; D014463:Ultrasonography; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*