title: Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia.
abstract: OBJECTIVE
  To determine the histopathological differences after varicocele repair in testicular tissue in males with nonobstructive azoospermia.
  
  
  METHODS
  Between 2009 and 2014, 45 men with complete azoospermia and palpable varicocele, presenting with primary infertility of at least 1 year, undergoing varicocele repair at our institution were selected for the study. A standard systematic testicular 6-core Tru-Cut biopsy was performed during varicocele repair. Other biopsies were obtained from each testicle of all patients at the time of microscopic sperm extraction procedure.
  
  
  RESULTS
  Nineteen patients were selected for the study. Testicular biopsy specimens were classified as Sertoli cell only on preoperative histopathological analysis in 14 patients. After varicocele repair, focal spermatogenesis (n = 3) and late maturation arrest (n = 2) were found in these patients. Average Johnsen score was significantly increased after varicocelectomy (P = 0.003). Motile sperm was found in one patient on postoperative semen analyses and in 10 more patients in the microscopic sperm extraction procedure. Preoperative high serum follicle stimulating hormone level and venous reflux were significantly and negatively correlated with the increase in average Johnsen score (P < 0.05).
  
  
  CONCLUSIONS
  Our findings suggest significant improvement in testicular histology after varicocele repair.
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ustuner
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Yavuz
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Ciftci
authors.affiliation: Department of Urology, VM Medical Park Hospital, Kocaeli, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Saribacak
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Bahri Serkan
authors.initials: BS
authors.lastname: Aynur
authors.affiliation: Department of Urology, Darica Farabi State Hospital, Kocaeli, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yasar
authors.affiliation: Department of Urology, School of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
authors.forename: Mustafa Melih
authors.initials: MM
authors.lastname: Culha
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001706:Biopsy; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012708:Sertoli Cells / Q000473:pathology*; D013091:Spermatogenesis; D014646:Varicocele / Q000473:pathology / Q000503:physiopathology / Q000601:surgery