Subinguinal Mikroskobik Varikoselektomi Esnasında Bağlanan Ven Çapı Ve Sayısının Post Operatif Sperm Parametrelerine Etkisi

Öz

Oligozoospermi ve azoospermi tanısı olan hastalarda subinguinal mikroskobik varikoselektomi ameliyatı esnasında bağlanan internal spermatic venlerin sayısı ve çapının postoperatif spermiogram parametreleri üzerindeki etkisini değerlendirmek. Bu prospektif çalışmaya 2021–2022 yılları arasında sol klinik varikosel nedeniyle subinguinal mikroskobik varikoselektomi uygulanan 14 infertil hasta dahil edildi. Genetik, hormonal veya fertiliteyi etkileyebilecek diğer faktörleri olan hastalar çalışma dışı bırakıldı. Operasyon esnasında bağlanan internal spermatik venlerin sayı ve çaplarının; operasyon öncesi ve operasyon sonrası bakılan spermiyogram parametrelerindeki değişime etkisi prospektif olarak incelendi. Hastaların ortalama yaşı 30,64 ± 6,68 yıl idi. Ameliyat esnasında bağlanan internal spermatic venlerin ortalama sayısı 5,5 ± 2,37 olarak bulundu. Bağlanan venlerin ortalama çapı 3,32 ± 1,15 mm, en küçük venin çapı ise 0,96 ± 0,88 mm idi. Operasyon esnasında bağlanan venlerin toplam çapı ortalama 8,77 ± 2,72 mm, venlerin ortalama çapı 1,79 ± 0,81 mm olarak ölçüldü. Operasyon esnasında 8 ve üzeri ven bağlanan hastalarda ve bağlanan venlerin ortalama çapının ≤1,5 mm olduğu hastalarda Kruger morfolojisinde daha belirgin iyileşme gözlendi. Ayrıca, bağlanan venlerin toplam çapı ≤8 mm olan hastaların spermiyogram total motil sperm yüzdesinde iyileşme, ≥10 mm olanlara göre anlamlı olarak daha yüksek görüldü (p < 0,005). Subinguinal mikroskobik varikoselektomi sırasında daha fazla sayıda ve daha küçük internal spermatic ven bağlanması, postoperatif spermiogram parametrelerinde daha olumlu değişikliklerle ilişkilidir.

Anahtar Kelimeler

• Subinguinal Mikroskobik Varikoselektomi
• İnternal Spermatik Ven
• infertilite

The Impact of the Diameter and Number of Veins Ligated During Subinguinal Microscopic Varicocelectomy on Postoperative Sperm Parameters

Öz

To evaluate the effect of the number and diameter of ligated internal spermatic veins during subinguinal microscopic varicocelectomy on postoperative spermiogram parameters in patients with oligozoospermia and azoospermiaThis prospective study included 14 infertile patients who underwent subinguinal microscopic varicocelectomy for left clinical varicocele between 2021 and 2022. Patients with genetic, hormonal, or other conditions that could affect fertility were excluded. The number and diameters of ligated internal spermatic veins were recorded intraoperatively. Postoperative changes in spermiogram parameters, including total motility and Kruger morphology, were analyzed in relation to vein number and diameter. The mean age of the patients was 30.64 ± 6.68 years. The mean number of ligated internal spermatic veins was 5.5 ± 2.37. The mean diameter of the largest ligated vein was 3.32 ± 1.15 mm, while the smallest measured 0.96 ± 0.88 mm. The mean total diameter of all ligated veins was 8.77 ± 2.72 mm, with a mean vein diameter of 1.79 ± 0.81 mm. Greater improvement in Kruger morphology was observed in patients in whom more than 8 veins were ligated and whose mean vein diameter was ≤1.5 mm. Additionally, improvement in total motile sperm percentage was significantly higher in patients with a total ligated vein diameter ≤8 mm compared to those with ≥10 mm (p < 0.005) Subinguinal microscopic varicocelectomy involving ligation of a greater number of smaller internal spermatic veins appears to be associated with more favorable postoperative improvements in spermiogram parameters.

Anahtar Kelimeler

• Subinguinal Microscopic Varicocelectomy
• Internal Spermatic Veins
• Infertility

Kaynakça

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