title: Impact of extensive laparoscopic venous disconnection on the recurrence rate and sperm DNA quality in infertile varicocele patients.
abstract: BACKGROUND
  Although there are many literature examining the possible effects of varicocelectomy on classic semen parameters and recurrence rate, few published articles have examined the effect of conventional laparoscopic varicocelectomy on sperm DNA integrity.
  
  
  OBJECTIVE
  The objective was to evaluate the effect of extensive laparoscopic venous disconnections on the recurrence rate and sperm DNA damage in varicocele patients.
  
  
  METHODS
  Totally, 54 patients with varicocele underwent extensive laparoscopic venous disconnections were assessed by clinical evaluation, duplex scan, semen analysis, and sperm DNA fragmentation assay before surgery and after 6 and 12 months following surgery.
  
  
  RESULTS
  No intra- or post-operative complications were observed and out of 54 patients preoperatively complained from varicocele 2 (3.7%) patients' have recurrence during the follow-up period for 12 months. Out of 54 patients complaining from male infertility, 14 patients success to get pregnancy after 6 months with pregnancy rates of 25.92% and 22 (40.74%) after 12 months, and 28 patients (51.85%) had a preoperative DNA fragmentation index (DFI) >30%, decreased following surgery below 30% in 19 (35.18%) patients after 6 months, and 11 (20.37%) after 12 months, and the percentage of sperm with DFI > 30% was significantly decreased after 6 and 12 months, respectively (38.4 ± 10.6 vs. 31.3 ± 12.4, [P < 0.001] at 6 months, and 22.9 ± 13.2, [P < 0.001] after 1-year). Other spermatic parameter was significantly improved.
  
  
  CONCLUSIONS
  An extensive laparoscopic venous disconnection was significantly decreasing the recurrence rate, DFI and improving normal semen parameters and fertility.
authors.affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Al-Rafie Hospital, Makkah, KSA.
authors.forename: Alsayed Saad
authors.initials: AS
authors.lastname: Abdelaziz
authors.affiliation: Department of Urology, Al-Rafie Hospital, Makkah, KSA.
authors.forename: Waleed Ahmed
authors.initials: WA
authors.lastname: Burham
authors.affiliation: Department of Urology, Al-Rafie Hospital, Makkah, KSA.
authors.forename: Ahmed Yosef
authors.initials: AY
authors.lastname: Aboelsaad
authors.affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Dr. Soliman Fakeeh Hospital, Jeddeh, KSA.
authors.forename: Yaser Ali
authors.initials: YA
authors.lastname: Badran
authors.affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Salman Bin Abdulaziz University, Alkharji, KSA.
authors.forename: Abul-Fotouh Abdel-Maguid
authors.initials: AF
authors.lastname: Ahmed
keywords: Extensive; infertility; laparoscopic; sperm; varicocele