Does varicocele grade predict the postoperative changes of semen parameters following left inguinal micro-varicocelectomy?

Objective: To evaluate the relationship between preoperative grade and postoperative changes of semen parameters following left inguinal varicocelectomy. Methods: This study included 44 patients undergoing left microsurgical inguinal varicocelectomy. Internal spermatic veins were classified as large (4 mm or more in diameter), medium (2e4 mm), or small (2 mm or less). Changes in sperm activity, morphology and count were estimated perioperatively. The introperative findings and semen parameters were compared between varicocele groups of grades 2 and 3. Results: Both sperm motility and count improved significantly postoperatively (from (31.9 ± 16.3)% to (47.3 ± 15.5)%, from (28.1 ± 28.1) ± 106/mL to (52.1 ± 74.2) ± 106/mL). In varicoceles with grade 2 and 3, significant differences were found in the number of large veins (0.4 ± 0.6 vs. 1.2 ± 0.7, p < 0.001) and ultrasonographic maximum diameters of spermatic vein in supine and standing positions (2.3 ± 0.4 cm vs. 2.8 ± 0.6 cm, 3.1 ± 0.7 cm vs. 3.9 ± 0.7 cm, p = 0.001 and 0.001 respectively). However no difference of changes in sperm motility and count was detected ((16.3 ± 13.5)% vs. (14.4 ± 12.6)%, (30.5 ± 84.4) ± 106/mL vs. (12.9 ± 20.6) ± 106/mL respectively, p = 0.65 and 0.40 respectively). Conclusion: Preoperative varicocele grade might not predict postoperative semen changes regardless of possible existence of anatomic and ultrasonographic associations.