Varicocele repair has been proven to improve semen parameters in 50% to 80% of men and surgical methods successfully eliminate >90% of the varicoceles (16,34,35,43). Pregnancy rates following laparoscopic varix ligation (26-46%) are similar to those reported following open repair (49,50). The american urological association's Best Practice Guidelines identified only two well-designed, randomized, prospective controlled studies of men with palpable varicoceles, abnormal semen quality, and normal spouses (16). In one study there was a significant increase in testicular volume and semen quality but no increase in pregnancy rates after repair was demonstrated (51). The other study showed a 60% conception rate following varicocele repair compared to a 10% conception rate in the untreated group (52). American urological association's Best Practice Guidelines considers varicocele repair for infertile men with palpable varicoceles an appropriate option because of the proven improvement in semen parameters, low operative risks, and the possibility of increased fertility (16).
bEthicon, Cincinnati, OH. Johnson & Johnson, Somerville, NJ.
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