Successful Adolescent Varicocelectomy Improves Total Motile Sperm Count
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New article you should know about from JPS by Kim Priban DNP, RN
"Successful Adolescent Varicocelectomy Improves Total Motile Sperm Count"
Authors: Raymond Lay, Tanya Logvinenko, Michael P. Kurtz, Saafia Masoom, Alyssia Venna & David A Diamond
Full article: https:/doi.org/10.1016/j.jpedsurg.2023.08.007
Abstract
Background:
Management of the adolescent varicocele focuses on optimizing fertility potential, but to date there is limited data on the success of varicocelectomy on optimizing semen parameters for individual adolescent patients. We reviewed our database of over 1600 adolescent varicocele patients to find those with pre- and postoperative semen analyses to determine the impact of varicocele correction.
Methods:
15 Tanner stage V patients with unilateral clinically apparent left-sided with pre- and postoperative semen analyses were identified. Mixed models were used to compare semen parameters pre- and post-varicocelectomy in patients with successful management.
Results:
Complete elimination of the varicocele was achieved in 12/15 (80%) patients. Three patients had persistent varicocele (with down-grading in two) and declined further intervention. Median time between pre- and postoperative semen analyses was 24.2 months. For those with successful varicocele correction, total motile sperm count (TMSC) improved in all but one (Figure 1), with an average increase of 44.0 million (95% CI: 18.7–69.3) in post-varicocelectomy analyses compared to pre-varicocelectomy (p = 0.0016). Mean percent improvement was 649.2%. It went from abnormal to normal (≥20 million/cc) in 55.6% (5/9). For the three patients with persistent varicocele, one had improved TMSC from abnormal to normal range, one had worsening within normal range, and one had effectively no change.
Conclusion:
Successful correction of adolescent varicocele may improve TMSC. In over half of our institution's cases, an abnormal value normalized. Surgical intervention may be considered for adolescent varicoceles associated with abnormal semen parameters.
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What is the best approach in preserving future fertility in a pediatric male who has a varicocele? Hi, I'm Kim Pribben, a research fellow from Cincinnati Children's, and this is an article I think you should know. This article is a retrospective treatment study out of the University of Rochester School of Medicine in Boston Children's Hospital, seeking to understand if a varicoceolectomy during adolescence had a. Positive correlation with increased sperm concentration and total modal sperm counts. And what did they find? For the study, 15 Tanner stage 5 patients who had a varicosolectomy were identified. 12 of those patients achieved complete elimination of the varicocele. The median time then between the pre and post-operative semen analysis was 2 years, and in those patients that had that successful varicocele correction, Total modal sperm count improved in all but one patient with an average increase of 44 million. This led to the conclusion that while there is some controversy surrounding the early surgical treatment of a varicocele, it should really be strongly considered, especially when abnormal semen parameters arise. Like, share, and let us know what you think. Stay tuned for more articles we think you should know about.