Mp21-21 Adolescent Varicocelectomy and Sperm Parameter Enhancement: A Prospective Matched Cohort Analysis

You have accessJournal of UrologyPediatrics II (MP21)1 May 2024MP21-21 ADOLESCENT VARICOCELECTOMY AND SPERM PARAMETER ENHANCEMENT: A PROSPECTIVE MATCHED COHORT ANALYSIS Francis Petrella, Adele Raymo, Iman Sadri, Maria Camila Suarez Arbelaez, Vinayak Madhusoodanan, Daniel Nassau, and Ranjith Ramasamy Francis PetrellaFrancis Petrella , Adele RaymoAdele Raymo , Iman SadriIman Sadri , Maria Camila Suarez ArbelaezMaria Camila Suarez Arbelaez , Vinayak MadhusoodananVinayak Madhusoodanan , Daniel NassauDaniel Nassau , and Ranjith RamasamyRanjith Ramasamy View All Author Informationhttps://doi.org/10.1097/01.JU.0001008844.84871.17.21AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicocele, a common vascular abnormality surrounding the testis, is known to be associated with impaired semen parameters and male infertility in adults. However, its impact on the adolescent and young adult (AYA) population is less well known. The study aimed to assess the improvement in sperm parameters following varicocelectomy in the AYA population, comparing them to matched adult counterparts, and investigating potential advantages of early intervention. METHODS: A prospective analysis was conducted using a comprehensive database at the University of Miami from 2010 to 2022. We included AYA (under 25 years of age) men who underwent varicocelectomy. To ensure comparability, they were matched with adult patients (over 30 years of age) based on follicle-stimulating hormone (FSH) values, varicocele grade, and laterality (unilateral or bilateral) in a 1:2 ratio. Semen parameters were evaluated before and after surgery, including sperm count, motility, morphology, and overall semen quality. RESULTS: We included 45 patients in the Adolescents and Young Adults (AYA) category, and matched them with 116 adults based on FSH, varicocele grade and laterality, all of whom underwent microsurgical varicocelectomy. As expected, there were no discernible differences between the cohorts prior to the surgical intervention. However, post-varicocelectomy, the AYA group exhibited greater improvements as compared to the matched cohort. FSH levels in the AYA group was significant lower than in adults, 4.05 and 6.2 respectively (p<0.004). Furthermore, postoperative sperm concentration in the AYA men demonstrated a remarkable increase, with a median of 16 mill/ml, compared to 9 mill/ml in the adult group (p<0.002). Additionally, motility also displayed significant enhancement among the AYA men, with a median of 53%, surpassing the adult cohort's median motility of 41% (p<0.002). CONCLUSIONS: This study highlights the potential benefits of varicocelectomy as a viable treatment option for adolescents and young adults with varicocele, particularly those with impaired semen parameters. By intervening at an earlier stage of development, patients in this age group can achieve significant improvements in semen quality, as compared to their adult counterparts. These findings underscore the importance of considering varicocelectomy as a valuable therapeutic approach for the younger demographic, potentially alleviating future fertility concerns. Source of Funding: Supported by NIDDK grants R01 DK130991, UE5 DK137308, and Clinician Scientist Development Grant from American Cancer Society to RR © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e338 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francis Petrella More articles by this author Adele Raymo More articles by this author Iman Sadri More articles by this author Maria Camila Suarez Arbelaez More articles by this author Vinayak Madhusoodanan More articles by this author Daniel Nassau More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement PDF downloadLoading ...