Varicocele: spermiogram, testicular biopsy, plasma testosterone. Results of therapy (author's transl)
Abstract
In 73 patients with unilateral (70 patients) and bilateral (3 patients) varicocele and subfertility as a clinical finding, spermiograms, testicular biopsies, and plasma testosterone levels were examined for their prognostic evaluation, and therapeutic conclusions were drawn. The high ligature of the internal spermatic vein in the presence of a normal plasma testosterone level resulted, without accompanying therapy, in an improvement of normalization of the spermiogram in 23.3% of cases, and only in 7% did a pregnancy occur. A significant improvement of these results could be achieved through additional combined therapy with Mesterolone and Clomiphene. In primary testosterone deficiency, a combination of surgical correction and chemotheraphy (Mesterolone and Clomiphene) gave relatively satisfactory results. Primary sperm counts below 10(6)/ml, a motility index under 30%, and histologically proven desquamation of the germ epithelium in the testicular biopsy are to be regarded as extremely grave prognostic criteria.
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