The Effect Of High-Ligation Varicocelectomy On Testicular Blood Flow And Semen Quality

Objective To investigate the effect of ipsilateral high-ligation varicocelectomy on testicular blood flow and semen quality using color Doppler sonography (CDS).Methods A total of30patients clinically diagnosed with left varicocele who underwent a ipsilateral high-ligation varicocelectomy were examined with CDS for the parameters of the peak systolic velocity(PSV), end diastolic velocity(EDV), resistive index(RI) and pulsatility index(PI) of bilateral intratesticular centripetal artery before and at least6months after surgery. We also evaluated preoperative and postoperative semen quality.Results The mean values of RI,PI and PSV in the left intratesticular centripetal artery decreased significantly after surgery (P<0.001), whereas no significant change was observed in EDV(P>0.05). No significant difference was detected between the preoperative and postoperative blood flow parameters in the right intratesticular centripetal artery(P>0.05). In the semen analysis run six months after the operations statistically significant increases were found in sperm concentration(P<0.001), morphology percentage (P<0.001) and total motile sperm concentration (TMSC)(P<0.001). However,the linear correlation analysis showed that no significant correlation was found between sperm parameters and RI, PI values in the left intratesticular centripetal artery.Conclusions Our data shows that a significant improvement occurs in ipsilateral testicular hemodynamics and semen quality after ipsilateral High-ligation varicocelectomy. The decrease in RI and PI in the left intratesticular centripetal artery may be indicators of an increase in testicular arterial blood flow into the testicular tissue. The values of RI and PI in the intratesticular artery may be as an important index for forecasting the effect of surgical.