Impact of intra‐operative doppler ultrasound assistance during microsurgical varicocelectomy on operative outcome and sperm parameters

Abstract

Background:Varicoceles are important cause for primary infertility. This study was mainly undertaken to study the importance of vascular Doppler assistance in microscopic Varicocelectomy in comparison with microscopic Varicocelectomy alone.Material and Methods:A randomized controlled study was conducted in a tertiary care centre among 60 patients who were divided equally in to two groups. First group undergone microscopic Varicocelectomy alone and second group had undergone intra operative vascular Doppler assisted microscopic Varicocelectomy. The baseline characteristics, operative time, number of veins ligated, number of arteries and lympatics spared, Duration of hospital stay and return to work, pregnancy rates and sperm parameters were recorded during the time of follow up.Results:There was a significant difference in duration of the operation bilaterally. More number of arteries and lymphatics were spared in IVDU – MV group. There was no significant change in the sperm morphology during follow up between the two groups. The sperm motility improved significantly in IVDU – MV group during post operative follow up. The a + b grade of the sperm also increased significantly in IVDU – MV group than MV group. The rate of pregnancy was little higher in Doppler assisted group than the MV group which was not statistically significant. Conclusion:The use of Intra operative vascular Doppler helps in preservation of more number of testicular arteries and removal of more number of veins to help the improvement in spermatogenesis.