Adolescent Varicocele – Male Fertility problem

Pugachev A.G., Evdokimov V.V., Zaharikov S.V., Erasova V.I.

Introduction. Demographic problems in Russian Federation require paying more attention to reproductive health of adolescents. This problem worries pediatricians: only 20% of senior school graduates are considered healthy. WHO reports 50% contribution of male factor in infertile couples. Among the reasons causing male infertility varicocele can be emphasized. Numerous of long-term researches are dedicated to male infertility in adults. Far less researches of varicocele in kids and adolescents can be found. That could be connected with particularity of diagnostic and treatment. Varicocele influence on spermatogenesis and surgery efficiency are still discussed and researched. Materials and methods. 500 patients with varicocele underwent surgery for last 5 years in Scientific Research Institute of Urology. Diagnosis was based on physical examination, ultrasound and Doppler investigation. Left-sided varicocele was in 87% of cases, right-sided in 2%, two-sided in 11%. Spermatogenesis status was determined due to WHO recommendations. In a group of 226 adolescents after parental permission ejaculate analyses was taken. Age varied from 16 to 18. Statistic analyses was used. Results. Mean level of main ejaculate characteristics was lower than normally. After the surgery sperm cells concentration increased meanly from 35 to 61 mln/ml, quantity of alive cells meanly increased from 71% to 77%. “A” category sperm cells improved meanly from 18% to 36%. In adult group significant improvement of spermatogenesis was not mentioned. Conclusions. Varicocele influences spermatogenesis, may lead to infertility. Surgery in adults does not cause any significant changes in spermatogenesis. In adolescents in most cases surgery gives positive results.

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