Matthew S Christman1, Stephen A Zderic, Thomas F Kolon. 1. Naval Medical Center San Diego (MSC), San Diego, California; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: matthew.christman@med.navy.mil.
Abstract
PURPOSE: We determined relative semen quality in youths diagnosed with cryptorchidism or varicocele as a surrogate for ultimate paternity potential. We hypothesized that youths with varicocele would be at lower risk for subfertility based on semen analysis than their counterparts with surgically corrected cryptorchidism. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with a history of cryptorchidism or varicocele. Patients were placed in 1 of 3 groups based on diagnosis, including group 1-untreated varicocele, group 2-treated bilateral cryptorchidism and group 3-treated unilateral cryptorchidism. Age and semen parameters (density, volume, count, motility and total motile count) were compared for each group. RESULTS: A total of 193 subjects were studied. Median age was 18.3 (IQR 18.1-19.3), 18.6 (IQR 18.3-21.0) and 18.5 years (IQR 18.2-19.6) in the 76 group 1, 21 group 2 and 96 group 3 patients, respectively. Total motile count in groups 1, 2 and 3 was 14.6 (IQR 4.7-29.3), 4.0 (IQR 0-38.0) and 34.1 million sperm (IQR 7.6-90.8), respectively. No significant difference existed between the groups in age, volume (p = 0.106) or motility (p = 0.197). However, density (p = 0.0001), count (p = 0.0001) and total motile count (p = 0.0002) achieved significance. For each of these parameters a significant difference was noted for group 1 vs 3 and group 2 vs 3 but not for group 1 vs 2. CONCLUSIONS: The semen quality of youths with varicocele more closely resembles that of youths with bilateral cryptorchidism than those with unilateral cryptorchidism. This is concerning and should challenge current treatment paradigms for adolescents with varicocele.
PURPOSE: We determined relative semen quality in youths diagnosed with cryptorchidism or varicocele as a surrogate for ultimate paternity potential. We hypothesized that youths with varicocele would be at lower risk for subfertility based on semen analysis than their counterparts with surgically corrected cryptorchidism. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with a history of cryptorchidism or varicocele. Patients were placed in 1 of 3 groups based on diagnosis, including group 1-untreated varicocele, group 2-treated bilateral cryptorchidism and group 3-treated unilateral cryptorchidism. Age and semen parameters (density, volume, count, motility and total motile count) were compared for each group. RESULTS: A total of 193 subjects were studied. Median age was 18.3 (IQR 18.1-19.3), 18.6 (IQR 18.3-21.0) and 18.5 years (IQR 18.2-19.6) in the 76 group 1, 21 group 2 and 96 group 3 patients, respectively. Total motile count in groups 1, 2 and 3 was 14.6 (IQR 4.7-29.3), 4.0 (IQR 0-38.0) and 34.1 million sperm (IQR 7.6-90.8), respectively. No significant difference existed between the groups in age, volume (p = 0.106) or motility (p = 0.197). However, density (p = 0.0001), count (p = 0.0001) and total motile count (p = 0.0002) achieved significance. For each of these parameters a significant difference was noted for group 1 vs 3 and group 2 vs 3 but not for group 1 vs 2. CONCLUSIONS: The semen quality of youths with varicocele more closely resembles that of youths with bilateral cryptorchidism than those with unilateral cryptorchidism. This is concerning and should challenge current treatment paradigms for adolescents with varicocele.