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What are the success rates for varicocelectomies?

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Success rates can be measured in terms of resulting pregnancy rates: 64% of men will establish a pregnancy within one year of varicocelectomy. This compares to 16% of men whose wives will conceive without undergoing a varicocelectomy during the same period.

Success rates can also be measured by change in semen analysis results. 65% of men will show a significant improvement in the semen analysis within 12 months. A significant change is defined as a doubling of the total motile count. The total motile count is the calculated number of sperm that the man actually ejaculates.

Men with larger varicoceles will show more significant improvement. In these men, 69% will have a three-fold improvement in the total motile count in the ejaculate. Many men have a large varicocele on one side and a small varicocele on the other side. A recent study addressed whether, in these cases, both varicoceles should be repaired or if just the larger one should. 65% of men with bilateral (two sided) varicoceles with a small varicocele on one side and a large varicocele on the other chose to have both varicoceles repaired. This group showed a 104% increase in the total motile count. 26% of the men decided to have only the left side operated on and they showed an average improvement of 45% in the total motile count. In general, even if only a small varicocele is found on the opposite side of a large varicocele, the current feeling is that they should both be repaired.

Another study of 25 men older than 45 years of age showed an average preoperative concentration of 12.7 million/cc, a motility of 29.6% and a normal morphology (shape of 24.4%). Postoperatively, the average concentration was 20.3 million/cc. The average motility was 44.7% and the average motility was 30.7% normal morphology. It would appear that even older men with long standing varicoceles will show significant improvement from a varicocelectomy.
 

 


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