Abstract
Purpose
We retrospectively reviewed infertile Japanese males for testicular volume discrepancies (D) and semen parameters to evaluate whether left grade II–III varicoceles (V) cause testicular damage.
Methods
Seventy-seven patients who had idiopathic male infertility and 88 who had V without other causes of infertility were examined. We excluded cases of azoospermia. Testicular volume was measured using a punched-out orchidometer. D was defined as a size difference of at least 3 ml. The frequency of D was compared between the patients with and without V. The semen parameters were reviewed in association with D and V.
Results
The mean left and right testicular volumes were 19.4 and 20.1 ml, respectively (p < 0.001). D with a smaller left testis was more common in V+ cases than in V− cases (26.1 vs. 13.0%, p = 0.0351). The sperm count and motility were also significantly lower (p = 0.0213 and p = 0.0217, respectively) in the D+ patients with a smaller left testicular volume.
Conclusions
In the patients with V, D was more common than in those without V. The semen parameters were worse if D was present in the patients with V. These results indicated that V could induce testicular atrophy and negatively affect semen quality. Therefore, the ipsilateral reduced testicular volume is considered to be a sign of persisting testicular damage by V.
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References
Nagler HM, Luntz RK, Martinis FG. Varicocele. In: Lipshultz LI, Howards SS, editors. Infertility in the Male. St. Louis: Mosby; 1997. p. 336–8.
Pryor JL, Howards SS. Varicocele. Urol Clin North Am. 1987;14:499–513.
Jarow JP, Coburn M, Sigman M. Incidence of varicocelesin men with primary and secondary infertility. Urology. 1996;47:73–6.
Kibar Y, Seckin B, Erduran D. The effects of subinguinal varicocelectomy on Kruger morphology and semen parameters. J Urol. 2002;168:1071–4.
Hsiao W, Rosoff JS, Pale JR, Greenwood EA, Goldstein M. Older age is associated with similar improvements in semen parameters and testosterone after subinguinal microsurgical varicocelectomy. J Urol. 2011;185:620–5.
Kass EJ, Belman AB. Reversal of testicular growth failure by varicocele ligation. J Urol. 1987;137:475–6.
Okuyama A, Nakamura M, Namiki M, Takeyama M, Utsunomiya M, Fujioka H, Itatani H, Matsuda M, Matsumoto K, Sonoda T. Surgical repair of varicocele at puberty: preventive treatment for fertility improvement. J Urol. 1988;139:562–4.
Gentile DP, Cockett ATK. The effect of varicocelectomy on testicular volume in 89 infertile adult males with varicoceles. Fertil Steril. 1992;58:209–11.
Sigman M, Jarow JP. Ipsilateral testicular hypotrophy is associated with decreased sperm counts in infertile men with varicoceles. J Urol. 1997;158:605–7.
Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertil Steril. 1993;59:613–6.
Takihara H, Sakatoku J, Fujii M, Nasu T, Cosentino MJ, Cockett ATK. Significance of testicular size measurement in andrology. I. A new orchiometer and its clinical application. Fertil Steril. 1983;39:836–40.
Costabile RA, Skoog S, Radowich M. Testicular volume assessment in the adolescent with a varicocele. J Urol. 1992;147:1348–50.
WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction. 4th ed. Cambridge, United Kingdom: Cambridge University Press; 1999.
Akashi T, Watanabe A, Komiya A, Fuse H. Evaluation of the Sperm Motility Analyzer System (SMAS) for the assessment of sperm quality in infertile men. Syst Biol Reprod Med. 2010;56:473–7.
Kruger TF, Menkveld R, Stander FS, Lombard CJ, Van der Merwe JP, van Zyl JA, Smith K. Sperm morphologic features as a prognostic factor in in vitro fertilization. Fertil Steril. 1986;46:1118–23.
Iwamoto T. Semen analysis. In: Japan Society for Reproductive Medicine, editor. Guidebook for reproductive medicine 2010. Tokyo: Kanehara Syuppan; 2010. p. 154–5.
Iwamoto T, Nozawa S, Yoshiike M, Hoshino T, Baba K, Matsushita T, Tanaka SN, Naka M, Skakkebaek NE, Jørgensen N. Semen quality of 324 fertile Japanese men. Hum Reprod. 2006;21:760–5.
Patel SR, Sigman M. Prevalence of testicular size discrepancy in infertile men with and without varicoceles. Urology. 2010;75:566–8.
Ku JH, Son H, Kwak C, Lee SE, Lee NK, Park YH. Impact of varicocele on testicular volume in young men: significance of compensatory hypertrophy of contralateral testis. J Urol. 2002;168:1541–4.
Sakamoto H, Ogawa Y, Yoshida H. Relationship between testicular volume and varicocele in patients with infertility. Urology. 2008;71:104–9.
Zorgniotti AW, MacLeod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril. 1973;24:854.
Naughton CK, Nangia AK, Agarwal A. Pathophysiology of varicoceles in male infertility. Hum Reprod Update. 2001;7:473–81.
Skoog SJ, Roberts KP, Goldstein M, Pryor JL. The adolescent varicocele: what’s new with an old problem in young patients? Pediatrics. 1997;100:112–21.
Kondo Y, Ishikawa T, Yamaguchi K, Fujisawa M. Predictors of improved seminal characteristics by varicocele repair. Andrologia. 2009;41:20–3.
Fuse H, Akashi T, Mizuno I, Nozaki T, Watanabe A. Postoperative changes of sperm chromatin heterogeneity using acridine orange staining in varicocele patients. Arch Androl. 2006;52:223–6.
Marks JL, McMahon R, Lipshultz LI. Predictive parameters of successful varicocele repair. J Urol. 1986;136:609–12.
Yamamoto M, Katsuno S, Yokoi K, Hibi H, Miyake K. The effect of varicocelectomy on testicular volume in infertile patients with varicoceles. Nagoya J Med Sci. 1995;58:47–50.
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Komiya, A., Watanabe, A., Kawauchi, Y. et al. Testicular volume discrepancy is associated with decreased semen quality in infertile Japanese males with varicoceles. Reprod Med Biol 11, 117–121 (2012). https://doi.org/10.1007/s12522-011-0118-1
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DOI: https://doi.org/10.1007/s12522-011-0118-1