Study of spermogram and sex hormones before and after cure of subinguinal varicocele in infertile patients

Abstract

Background: Varicocele is defined as an abnormal dilation of the veins of the pampiniform plexus. Studies have shown that surgery can improve the sperm quality and fertility in initially infertile patients. However, the subinguinal approach by microdissection is increasingly becoming the preferred choice. Our study aimed at investigating the contribution of varicocele cure by sub-inguinal approach without microdissection in infertile patients at the Yaoundé Central Hospital, Cameroon.

Methods: This was an analytical study that spanned a period from 2014 to 2018. It was carried out in the Urology and Andrology Department of the Yaoundé Central Hospital, Cameroon.

Results: We studied 71 patients. Preoperatively, we observed spermogram abnormalities such as asthenospermia (80.3%), oligospermia (62%), teratospermia (46.5%) and azoospermia (11.3%), and hormonological abnormalities such as subnormal testosterone and high FSH levels in 88.7% of patients. After a minimum follow-up of one year on average, we had an improvement in spermographic parameters (especially asthenospermia and oligospermia) but also in FSH and testosterone levels of 43.7%, 64.8% and 31% respectively. In the same way, 23 pregnancies were recorded among the wives of the patients followed.

Conclusion: The subinguinal varicocele treatment without micro-dissection brings a significant improvement in the increase of sperm count and mobility but not in the morphology. Like all other treatments, it improves sex and pregnancy hormone levels.