title: Prognostic Predictors of Fertility in Young Adult Patients With Varicocele: Peak Retrograde Flow Velocity and Reflux Grade.
abstract: OBJECTIVE
  The purpose of this study was to determine prognostic factors affecting semen parameters in patients with varicocele during the postadolescent period.
  
  
  METHODS
  This study was approved by the Institutional Review Board. Between May 2013 and May 2015, we prospectively obtained demographic and sonographic data from postadolescent patients with varicocele. Potential risk factors affecting semen parameters, including age at diagnosis, height, weight, body mass index, varicocele laterality, varicocele grade, left testicular volume, right testicular volume, total testicular volume, testicular atrophy index, testicular volume differential, right and left maximum vein diameters, peak retrograde flow velocity, reflux flow volume, and reflux grade in both supine and standing positions, were recorded.
  
  
  RESULTS
  The left peak retrograde flow velocity, reflux flow volume, and reflux grade in the supine and standing positions, left testicular volume, right testicular volume, total testicular volume, and follicle-stimulating hormone level were found to be associated with abnormal semen parameters (P < .05). By multivariate analysis, the follicle-stimulating hormone level was associated with the sperm concentration and morphologic characteristics, and the left peak retrograde flow velocity in the standing position was associated with deterioration of sperm motility and morphologic characteristics. Additionally, the left reflux grade in the standing position was associated with the sperm concentration, and the left testis volume was associated with motility.
  
  
  CONCLUSIONS
  The left peak retrograde flow velocity and reflux grade in the standing position were significantly associated with all semen analysis parameters. This finding supports the use of testicular duplex Doppler sonography as a noninvasive tool for evaluation of testicular function in patients with varicocele and helps clinicians determine patients' fertility status.
authors.affiliation: Department of Radiology, Mevki Military Hospital, Ankara, Turkey drsametverim@yahoo.com.
authors.forename: Samet
authors.initials: S
authors.lastname: Verim
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Uguz
authors.affiliation: Department of Radiology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Celikkanat
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Guragac
authors.affiliation: Department of Public Health, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Turker
authors.initials: T
authors.lastname: Turker
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Bahadir
authors.initials: B
authors.lastname: Topuz
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Demirci
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Bilal Firat
authors.initials: BF
authors.lastname: Alp
authors.affiliation: Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Hasan Cem
authors.initials: HC
authors.lastname: Irkilata
authors.affiliation: Department of Radiology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Sağlam
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D015331:Cohort Studies; D005298:Fertility / Q000502:physiology*; D006801:Humans; D008297:Male; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013076:Sperm Count / Q000706:statistics & numerical data; D013081:Sperm Motility / Q000502:physiology; D013737:Testis / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D014646:Varicocele / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055815:Young Adult
keywords: Doppler sonography; adult; semen analysis; varicocele; vascular ultrasound; young