title: Left-sided grade 3 varicocele may affect the biological function of the epididymis.
abstract: OBJECTIVE
  Varicocele is present in approximately 30-40% of men evaluated for infertility and in 10-20% of the general male population, but the association between varicocele, compromised semen quality and male infertility remains unclear. This indicates that varicocele may impair spermatogenesis or in some other way mitigate sperm quality. Better understanding of criteria for the selection of men who will benefit from varicocele repair would improve the clinical management of men with impaired semen quality and varicocele.
  
  
  METHODS
  To further understand the effect of varicocele repair by embolization in men with grade 3 varicocele, 50 men referred for infertility with varicocele were evaluated before and after embolization.
  
  
  RESULTS
  There was a significant improvement in total sperm count (25.5 ± 4.7 million to 78 ± 11 million, p < 0.001) and sperm motility (slowly and rapidly progressive) (31.5 ± 2.9% to 45 ± 2.5%, p < 0.001) after spermatic vein embolization, comparing baseline to 3 month post-treatment follow-up data. Furthermore, alpha-glucosidase (specific epididymis-derived protein) increased from 61.7 ± 5.7 U to 84.7 ± 7.0 U (p < 0.05) and sperm droplets decreased from 14.2 ± 1.5% to 11.0 ± 1.0% (p < 0.05).
  
  
  CONCLUSIONS
  The results indicate improved epididymal function and suggest that left-sided grade 3 varicocele may affect the epididymis in addition to effects on the testis.
authors.affiliation: Department of Medicine/Huddinge, Karolinska Institutet and Centre for Andrology and Sexual Medicine, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Lehtihet
authors.forename: Stefan
authors.initials: S
authors.lastname: Arver
authors.forename: Bo
authors.initials: B
authors.lastname: Kalin
authors.forename: Ulrik
authors.initials: U
authors.lastname: Kvist
authors.forename: Ake
authors.initials: A
authors.lastname: Pousette
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D004822:Epididymis / Q000503:physiopathology; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055101:Semen Analysis; D012720:Severity of Illness Index; D013076:Sperm Count; D013081:Sperm Motility; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D000520:alpha-Glucosidases
chemical_list: D000520:alpha-Glucosidases
keywords: epididymal function; human sperm morphology; male infertility; semen analysis; seminal parameters; varicocele; vein embolization