Relationship Between Sperm Quality Recovery And Age After Repairing Varicocele By Different Surgical Methods.

Research backgroundFrom the original description two thousand years ago,we have made great progress in the epidemiology,pathophysiology,diagnosis and treatment of varicocele,but varicocele is still a controversial disease.Although there are numerous studies and data describing varicocele correction that can improve semen parameters,improve fertility,pain,and hypogonadism in most patients,it is clear that several plausible theories have not been confirmed.Not only that,the indications for varicocele surgery have not been clearly defined.By discussing the relationship between the recovery of sperm parameters and age after repairing varicocele by different surgical methods,it is possible to understand whether patients with varicocele can benefit from surgery and can help clinicians and patients choose treatment.ObjectiveTo explore the relationship between the recovery of sperm parameters and age after repairing varicocele with different surgical methods,so as to provide a theoretical basis for clinical surgical treatment.MethodThe study was conducted from January 2014 to December 2017 at the First Affiliated Hospital of Zhengzhou University in Henan Province.We retrospectively studied 418 patients with primary infertility aged 22-40 years.418 patients were divided into 3 groups according to the surgical method.According to the age factor,each component was divided into 2 groups,as follows,Group I:retroperitoneal high ligation group(N=143),group Ia:age 22-30 years(N=75)Ib group:age 30-40(N=68);group II:laparoscopic group,IIa Group:age 22-30 years(N=80),group IIb:age 30-40(N=72);group III:microscope group,group IIIa:age 22-30 years old(N=63)group IIIb:Age is 30-40(N=52).All patients were diagnosed as varicocele by physical examination and color ultrasonography,and there was abnormality in semen analysis.This study was compared with the semen analysis of semen samples in the last 12 months after surgery.The indicators of comparison were sperm motility/%,density/(×10~5/ml),and malformation/%.All data were statistically analyzed using SPSS version 20,and the test methods such as t-test,row*rikka square test and LSD test were used.ResultsThrough this study,it was found that:1.The preoperative sperm motility and density of the group aged 22-30 years were higher than those of the age group of 31-40 years old.The preoperative sperm abnormality rate of the group aged 22-30 years was lower than that of the age group of 31-40 years old,indicating that sperm quality was negatively correlated with age;2.sperm motility,sperm density and deformity after surgery in each group The rate was improved compared with preoperative,indicating that the varicocele was effective after the surgical repair of the sperm quality;3.The age group of 22-30 years old and the age group of 31-40 years showed microscope pair It is more effective to improve sperm motility,density and deformity rate,and laparoscopically,the lowest post-peritoneal ligation is the lowest;4.In the same surgery,the increase of sperm motility,the increase of density and the decrease of sperm deformity rate are There was no significant difference between the 22-30 age group and the 31-40 age group,indicating that the improvement in sperm quality after surgery was not related to age.Conclusions1.In the case of the same surgical procedure,the improvement in sperm quality is not related to age.It is recommended that the elderly patients undergo surgical treatment.2.For the varicocele surgery,the microscope is still the first choice,and the gain in sperm quality is the absolute leading position.3.Although the improvement of sperm quality is not related to age,preoperative sperm quality is negatively correlated with age.It is still recommended that varicocele should be treated as soon as possible in order to have greater benefit in sperm quality.