2005, Number 2
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ABSTRACTaricoceles are the most frequent and easily to correct cause of infertility attributed to men factors and with an incidence of 15-20% in the general masculine population, of the 19-41% in men with primary infertility and 45-81% in men with secondary infertility. After surgery correction, it has been reported normalization of the seminal parameters in the 60 to 80% of the cases and frequency of pregnancies to the year of 43%. The objective of the study was to determine if there is an improvement in the seminal parameters in the patient postbilateral varicocelectomy with subinguinal macrosurgery technique and the impact in the fertility. There were included 24 patients with diagnostic of infertility associated with bilateral varicocele who were operated from April 1998 to September 2003. Bilateral varicocelectomy with subinguinal macrosurgery technique was performed and postsurgery semen analysis to the month 3, 6 and 12, to establish the modification in the seminal parameters and the frequency of pregnancies. It was practiced semen analysis presurgery with parameters of the World Health Organization and Kruger’s criteria for morphology. Friedman and Wilcoxon test was applied for concentration and spermatic motility and Cochran and McNemar test for morphology, a value of p <0.05 was significant. The average age was 32 years old, 79.2% had primary infertility and the average time of infertility was 3.6 years. In presurgery semen analysis was observed oligozoospermia in 38%, teratozoospermia in 71%, and astenozoospermia in 83%. There was an improvement in seminal parameters starting from the third month for motility and morphology, and from the sixth month for concentration. One year monitoring showed normal concentration and motility in 87% of the patients, and normal morphology in 83%. The global frequency of pregnancies was of 50%. There was not recurrence of varicocele, neither postsurgery complications. As conclusion, bilateral varicocelectomy with subinguinal macrosurgery technique is effective in the correction of varicocele, it is reproducible, with a minimum of morbidity, it has good aesthetic and functional results, improving pregnancy frequency due to the progressive spermatic concentration, mobility, and morphology increased.
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