Clinical Parameters and Semen Analysis in 716 Austrian Patients With Varicocele

OBJECTIVES To evaluate different clinical parameters in association with the presence and severity of varicocele in a large group of Austrian men. METHODS Records of 716 consecutive patients with clinical varicocele and infertility, who visited our andrology unit from 2001 to 2007, were retrospectively evaluated. The presence, grade, and side of any varicocele were recorded; varicoceles were confirmed by Doppler sonography. Semen samples, serum follicle-stimulating hormone, luteinizing hormone, estradiol, and testosterone levels were also assessed in all patients. RESULTS Mean age was 29.6 +/- 0.3 years; 30% of patients presented with grade I varicocele, 39.0% with grade II, and 30.3% with grade III varicocele. About 33.3% of patients presented with normozoospermia, followed by asthenozoospermia (17.9%), oligoasthenoteratozoospermia syndrome (14.2%), and oligozoospermia (13.2%). Sperm density significantly decreased with increasing grade of varicocele. Body mass index was inversely proportional to varicocele. Serum testosterone levels were higher in grade III varicoceles (5.7 +/- 0.2 nmol/L) compared with grade I (4.9 +/- 0.2 nmol/L) and grade II (5.0 +/- 0.1 nmol/L) varicoceles (P < .001; range, 0.4-16.6 nmol/L). CONCLUSIONS To our knowledge the current report is the first to describe a direct relationship between grade of varicocele and semen quality. Grade III varicocele was associated with decreased semen quality and, interestingly, with higher testosterone levels. Our study confirmed previous reports regarding the relationship between varicoceles and body mass index. UROLOGY 75: 1069-1073, 2010. (C) 2010 Elsevier Inc.