SUMMARY INFLUENCE OF SURGICAL TREATMENT OF VARICOCELE ON THE INDICATORS OF SPERMATOGENESIS IN ADOLESCENT AGE

Abstract

Introduction. The problem of varicocele due to male infertility is very significant. Varicocele is diagnosed in 15–20 % of adolescents, fertility problems are manifested in 20 % of adolescents with varicocele.Objective is to determine indications for surgical treatment of varicocele in adolescents, based on the dynamics of spermatogenesis and hormonal profile.Materials and methods. In the urological hospital of the short-term stay of the Regional Clinical Specialized Uroandrology Center in the period 2011–2016 755 varicocelectomies (271 laparoscopic, 484 microsurgical) were performed. Of these, 204 patients were under the age of 18 (adolescents living in the North Caucasian Federal District). The indication for the operation was impairments in the spermatogenesis (100 %), pain (40 %) and signs of testicular hypotrophy (12 %).Results. The main impairment in the spermatogenesis of adolescents was decreased motility of spermatozoa (asthenozoospermia) in 100 % of cases regardless of age, 14 % – oligozoospermia, 23 % – teratozoospermia and 26 % – mixed pathology. In 3–6 months after surgical treatment, 85 % of adolescents had normalization of ejaculate parameters also without correlation with age. At the same time, the indices of the spermogram improved by 20 % or more.Conclusion. The optimal therapeutic-diagnostic algorithm for varicocele in adolescents allows us to restore fertility in the shortest possible time without complications.

Keywords

• varicocele
• spermatogenesis
• fertility
• adolescents
• varicocelectomy