Effects of Varicocele Treatments in Adolescents: Changes of Semen Parameters after Early Varicocelectomy

Shin, Jae Wook; Kim, Soo Woong; Paick, Jae Seung

Abstract

Purpose
The aim of this study was to evaluate the role of semen analysis in adolescent varicocele patients, and determine the deleterious effects of varicocele on spermatogenesis, as reflected by semen analysis, in adolescent boys compared to infertile adults.
Materials and Methods
The seminal follow-up data of 47 adolescent patients (age range 16-20 years) and 68 adult patients (age range 29-50 years), who underwent a varicocelectomy for infertility, were compared. The results of the andrological and hormonal evaluations were also compared.
Results
The percentage of abnormal seminal parameters was lower in the adolescent group. Multiple seminal abnormalities were also less common in the adolescent group. Of the 18 adolescents who showed seminal abnormality, testicular volume discrepancy was demonstrated in only 5 (27.8%). The varicocelectomy significantly improved all the tested mean seminal parameters in both groups. However, the adolescent group showed earlier and more complete recovery than the infertile adult group. In a comparison of the patients with preoperative abnormal seminal parameters, only the adolescent group showed improvements in the mean seminal parameters 3 month after the varicocelectomy.
Conclusions
In late pubertal varicocele patients, semen analysis may be a useful tool in identifying those at risk of future subfertility. The comparison of the seminal results revealed less preoperative derangement and more prompt response to varicocelectomy in the adolescent than in the infertile adult group. Therefore, an early varicocelectomy may be advocated for adolescent patients with preoperative seminal abnormalities. (Korean J Urol 2005;46:481-486)