The evaluation of effectiveness of laparoscopic varicocoele ligation based on semen analysis and the vein diameter
Article published in Urologia Polska 2004/57/2.

authors

Piotr Chłosta ¹, Grzegorz Kata ², Artur A. Antoniewicz ², Tomasz Szopiński ², Michał Szymański ², Andrzej Borówka ²: ¹ Oddział Urologii Szpitala Specjalistycznego z Przychodnią EMC we Wrocławiu
Ordynator oddziału: dr med. Piotr Chłosta, FEBU
² Zespół Dydaktyki Urologicznej CMKP, Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie
Ordynator oddziału i kierownik zespołu: prof. dr hab. Andrzej Borówka

introduction: Varicocoele is present in approximately 10 per cent of male population. In around 35 per cent it is diagnosed when the patients seek medical consultation for infertility.
objectives: The aim of the study was to evaluate improvement of sperm count and morphology in patients who underwent laparoscopic varix ligation (LVL).
material and methods: In the period April 1998 March 2003 LVL procedures were carried out in 71 patients aged 17-32 yr. In 20 of them (28%) varicocoele was revealed in the process of diagnosing infertility. Semen analysis carried out in all patients before operation revealed 5,9-35 mln sperms per 1 mL with 15-59% of normozoospermia. Standard LVL was performed saving spermatic artery and ligating all veins. Semen analysis was carried out 90 days after the procedure.
results: In most patients spermatic vein enlargement and pain regressed 90 days after procedure (the varicoele diameter was <2,5 mm and <3 mm in 57,7 and 29,6 per cent cases, respectively). In over 60 per cent of patients postoperative semen analysis revealed increased number of sperms (7-40,1 mln/mL). In 90 per cent of patients normal motility of over 50 per cent of sperms was observed. Normozoospermia of >60 and >50 per cent existed in 11 and 82 per cent of patients, respectively.
conclusions: Laparoscopic varix ligation allows excellent identification of all spermatic veins and is highly effective in improving the semen parameters.