ABSTRACT

Purpose:

This study was designed to determine how often the testicular artery is accidentally ligated during varzcocelectomy with local anaesthesia and to compare the Impact of artery ligation and preservation on seminal parameters, particularly strict sperm mophology.

Method;

44 infertile patients with the diagnosis of varicocele were enrolled into the study. Semen analyses and testicular volume measurements were repeated afier a minumum period of three months postoperatively. The change in seminal parameters a(ier the operation was analysed in artery­ ligated and preserved groups.

Results:

Spermatic artery in1ury was determined in 19 (43.1 %) out of 44 patients. In overall patients, preoperative sperm cencentration increased {rom an average o(41± 281Cflml to 53"' 23 1Cflml (p< 0.05), forward motility (+4 plus+ 3 motility) increased {rom 51± 16 to 57 ± 12 (p···0.05) and preoperative 9 "' 7 % of normal sperm morphology (according to strict cr/teria) changed to an average o(8 ± 6% (p>0.05). In the artery ligated group, a statistically significant difference was recorded m sperm concentration after varicocelectomy whereas both sperm concentration and motility Improved significantly in the artery preserved group (p<0.05). The percentage o spermatozoa with normal morphology increased in neither groups (p 0.05). Testicular volumes did not reveal significant change in any groups postoperatively (p>0.05). The only difference observed between the two groups was the zmprovement in sperm motility in the artery-preserved group.

Conclusion:

Varicocelectomy in low grade varicoceles does not improve strict sperm morphology