NE-AUA 2006 Annual Meeting, September 28 - 30, 2006, The Westin Hotel & Rhode Island Convention Center Providence, Rhode Island
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Relationship of Grade and Hypotrophy to Semen Parameters in Boys with Adolescent Varicocele
David A. Diamond, MD, Stuart B. Bauer, MD, Joseph G. Borer, MD, Craig A. Peters, MD, Bartley G. Cilento, Jr., MD, Alan B. Retik, MD, Ilina Rosoklija, MPH, David Zurakowski, PhD.
Children's Hospital, Boston, MA,

Background: Surgical indications for correcting adolescent varicocele have included high varicocele grade and testicular hypotrophy. To date, these findings have not been correlated with semen parameters. The objective of our study was to determine whether or not a correlation exists between varicocele grade or testicular volume differential and total motile sperm count in adolescents.
Methods:Semen analyses were obtained in 51 Tanner Stage V adolescent males, ages 14 to 21 years (mean=18, SD=1.7). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending ultrasonographer. Statistical analysis was performed using ANOVA with Fisher least significant difference (LSD) adjustment for multiple group comparisons.
Results: Analysis of varicocele grades and total motile sperm counts demonstrated no correlation (rho=0.05, P=0.75) and no mean differences between the three grades (P=0.87, ANOVA). Analysis of testicular volume differentials revealed an inverse correlation between the amount of the differential and motile sperm counts (rho=-0.32, P<0.05) indicating that patients with a larger volume differential have significantly lower sperm counts. Pooling those with volume differentials >10% indicated a significant difference compared to patients with volume differentials <10% (P=0.03).

 

 

Volume Differential Categories

 

 

<10%

10-20%

>20%

P value

 

Total motile sperm count

 

 

 

 

 

(mean+SD, millions)

58+54

29+26

31+39

0.09

 

 

 

Pooled categories (>10%)

0.03

 

 

 

30+33 million

 

 


Conclusion: In Tanner V adolescents, varicocele grade does not correlate with total motile sperm count. However, testicular volume differentials of >10% in Tanner Stage V males with varicocele are associated with significantly lower total motile sperm counts. Volume differentials of 10-20% and >20% were not significantly different in total motile sperm counts. This lends credibility to a 10% volume differential as having physiological significance with regard to future fertility.


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