Clinical trial NCT03281915: the Effect of Different Modialites of Varicocelectomy on Semen Parameters in Patient With Normal Semen Analysis
Official title: Comparison Between Impact of Inguinal and Subinguinal Approaches of Varicocelectomy on Semen Parameters in Patients With Normal Semen Analysis
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Varicocele
Keywords: infertility
pain
pregnancy
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2017-09-13
Enrollment: 32
Sex: MALE
Minimum age (years): 19
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Male patients undergoing varicocelectomy while having normal semen parameters (doing surgery for other reasons eg. pain)

Brief summary: to evalute the effect inguinal and subinguinal approach of varicoceclectomy on semen parameter for patients complaining of varicocele with normal semen parameter (pain is the main complaint)

Detailed description: the varicocele is defined as dilated and incompetent veins within the pampiniform plexus of spermatic cord. varicocele has been described as the most common surgically correctable cause of male subinfertility.this is a disease that devolops during puberty when both endocrine and exocrine function of the testicle dramatically increases, along with testicular blood flow. varicocele only rarely detected in boys less than 10 years. left sided varicocle found in 15% of healthy young men.incontrast, the incidence in sub fertile men approaches 40% bilateral varicocele is uncommon in healthy men (less than 10%) but palpated in 20% in sub fertile men. in-general varicocele don't spontaneously regress. an accurate physical examination remain the corner stone of varicocele diagnosis.

several anatomic features contribute to the predominance of left sided varicocele is the left intrnal spermatic vein longer than the right and it typically joins the left renal vein at a right angle.as result of this character higher venous pressures fair transmited to the left spermatic vein and result in reterograde reflux of blood.

varicocle are associated with testicular atrophhy and varicocle correction can reverse atrophy in adolececnt. there is strong evidence affect semen quality it can cause abnormalties in concentration, motility and morphology.main defect is the motility.

indication of varicocelectomy:

1. Large varicoceles in adolescents
2. Childhood varicocele with testicular atrophy
3. Varicoceles with elevated FSH values, or low testosterone levels
4. Varicoceles with scrotal pain
5. Cosmetic indication
6. Male infertility with pathological semen analysis and varicocele

Eligibility criteria: Inclusion Criteria:

* age more than 19 years old
* primary varicocele

Exclusion Criteria:

* secondary varicocele recurrent varicocele age less than 19 years

Primary outcomes:
measure: Semen analysis
timeFrame: 3months
Secondary outcomes:
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: Assuit Medical School
state: Assuit
Study officials:
affiliation: unaffiliation
name: Ehab O Ahmed
role: STUDY_DIRECTOR
affiliation: unaffiliation
name: Mohamed I Taha
role: STUDY_CHAIR
affiliation: unaffiliation
name: Ahmed k mohamed
role: STUDY_DIRECTOR
References:
citation: Leslie SW, Sajjad H, Siref LE. Varicocele. 2023 Nov 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK448113/
citation: Wu X, Liu Q, Zhang R, Wang W, Gao Y. Therapeutic efficacy and safety of laparoscopic surgery versus microsurgery for varicocele of adult males: A meta-analysis. Medicine (Baltimore). 2017 Aug;96(34):e7818. doi: 10.1097/MD.0000000000007818.
citation: Canning DA. Re: Sperm Concentration and Forward Motility are Not Correlated with Age in Adolescents with an Idiopathic Varicocele and Symmetrical Testicular Volumes. J Urol. 2017 Sep;198(3):472. doi: 10.1016/j.juro.2017.06.068. Epub 2017 Jun 20. No abstract available.
citation: Schmidt B. Membranes in artificial organs. Artif Organs. 1996 May;20(5):375-80. doi: 10.1111/j.1525-1594.1996.tb04519.x.
citation: Sedaghatpour D, Berookhim BM. The Role of Varicocele in Male Factor Subfertility. Curr Urol Rep. 2017 Sep;18(9):73. doi: 10.1007/s11934-017-0713-8.