Erken Varikosel Ameliyatı için Yaş Gruplarına Göre Hormonal ve Sperm Profillerinden Elde Edilen Kanıtlar

Year 2025, Volume: 20 Issue: 3, 159 - 165, 20.10.2025

İsmail Ulus , Yusuf Şahin , İbrahim Hacıbey , Muhammet Murat Dinçer

https://doi.org/10.33719/nju1710242

Abstract

Amaç: Bu çalışmanın amacı, adölesan ve erişkin hastalarda varikoselektomi sonrası hormon ve semen parametrelerindeki yaşa bağlı farklılıkları değerlendirerek, genç hastalarda erken cerrahi müdahalenin gerekliliğini araştırmaktır.

Gereç ve Yöntemler: Subinguinal varikoselektomi uygulanan, preoperatif ve postoperatif döneme ait hormon ve semen profilleri tam olan 82 hasta retrospektif olarak analiz edildi. Hastalar yaşa göre, Grup 1 (<21 yaş, n=30) ve Grup 2 (>30 yaş, n=52) olacak şekilde 2 gruba ayrıldı. Hormon profilinde serum FSH, LH ve total testosteron düzeyleri incelenirken; semen parametrelerinde sperm konsantrasyonu, motilite ve morfoloji bulunmaktaydı. Bulgular ameliyat sonrası 6–12 ay içinde değerlendirildi.

Bulgular: Her iki grupta da operasyon sonrası semen parametrelerinde anlamlı düzelmeler gözlendi; ancak gruplar arasında düzelme derecesi açısından anlamlı bir fark yoktu (p>0.05). Buna karşın, testosteron düzeyinde anlamlı artış yalnızca Grup 2’de saptandı (p=0.017) ve bu artış Grup 1’e kıyasla da anlamlı derecede yüksekti (p=0.009). FSH düzeyleri hem preoperatif (p=0.006) hem de postoperatif (p=0.002) olarak Grup 2’de daha yüksekti; ancak her iki grupta da FSH ve LH düzeylerinde grup içi anlamlı değişiklik gözlenmedi.

Sonuç: Çalışmamızda varikoselektomi hem adölesan hem de erişkin hastalarda semen parametrelerini iyileştirirken anlamlı hormonal iyileşme yalnızca daha ileri yaş grubunda gözlenmektedir. Adölesanlarda FSH artışının olmaması, germ hücre hasarının erken evrede veya henüz mevcut olmadığını düşündürmektedir. Bu bulgular adölesan dönemde hormon profiline dayalı bireyselleştirilmiş tedavi stratejilerinin önemini vurgulamaktadır. Daha uzun takip süreli prospektif çalışmalar, yaşa bağlı tedavi kararlarının yönlendirilmesine katkı sağlayacaktır.

Keywords

adölesan , erişkin , hormon profili , semen analizi , varikoselektomi

Evidence from Hormonal and Semen Profiles Across Age Groups for Early Varicocelectomy

Abstract

Objective: To evaluate age-related differences in hormonal and semen parameter responses following varicocelectomy in adolescents and adults, and to explore whether early surgical intervention is justified in younger patients.
Materials and Methods: We retrospectively analyzed 82 patients who underwent subinguinal varicocelectomy and had complete pre- and postoperative hormone and semen profiles. Patients were divided into two age-based groups, group 1 (<21 years, n=30) and group 2 (>30 years, n=52). Hormonal parameters included serum FSH, LH, and total testosterone. Semen parameters included sperm concentration, motility, and morphology. Outcomes were assessed 6-12 months postoperatively.
Results: Both groups exhibited significant improvements in semen parameters postoperatively, with no significant differences in the degree of improvement between groups (p>0.05). In contrast, a significant increase in testosterone levels was observed only in group 2 (p=0.017), and this hormonal improvement was significantly greater than in group 1 (p=0.009). FSH levels were higher in group 2 preoperatively (p=0.006) and postoperatively (p=0.002), yet no significant intragroup changes in FSH or LH were detected.
Conclusion: While varicocelectomy improves semen parameters in both adolescents and adults, meaningful hormonal recovery appears to be limited to older patients. These findings suggest that early surgical intervention may not be necessary for all adolescents and highlight the importance of individualized, hormone-informed treatment strategies. Prospective studies with longer follow-up are warranted to guide age-specific clinical decision-making.

Keywords

adolescent , adult , hormone profile , semen analysis , varicocelectomy

Ethical Statement

The study was approved by the Bağcılar Training and Research Hospital Clinical Research Ethics Committee (Approval No: 2025/07/05/050).

Supporting Institution

No financial support was received for this study.

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