Microsurgical subinguinal varicocelectomy in "single testis" patients - a case series.

Introduction and Objectives. Varicocele affects one in ten adult men and one in four men with infertility. The exact mechanism through which it reduces male fertility is not known but surgical correction usually improves semen parameters. We consider the study of varicocele repair in single testis patients to be less biased by the presence of a healthy contralateral testicle and thus providing accurate results regarding the benefits of the procedure. Materials and Methods. This is a retrospective, descriptive, single-center study, where we analyzed data from the clinical records of patients diagnosed with varicocele and a history of contralateral orchiectomy during a period of 4 years. All patients had varicocele surgery done by the same surgeon and the same surgical procedure of microsurgical subinguinal varicocelectomy was used. We follow their pathological history, clinical findings, hormonal work-up and semen analysis from before the surgery until the present day. Results. There were six patients that corresponded to our criteria during the studied period. The patients were between 25 and 39 years old. All of them had right-sided orchiectomy for either benign or malignant disease and a left sided varicocele. Four of these patients presented for infertility of various lengths and two for clinical symptoms associated with the varicocele. Two patients that presented for infertility and were candidates for in-vitro-fertilization before varicocele repair managed to obtain natural pregnancies. All four patients that presented for infertility managed to obtain a pregnancy. The other two patients had their symptoms settled. Conclusions. Microsurgical subinguinal varicocelectomy is a straightforward way to relieve clinical symptoms and upgrade the fertility status of single testis patients. Microsurgical treatment of a varicocele in single testis patients could result in the use of a safer, less invasive and less expensive artificial reproductive technique and a higher natural pregnancy rate. [ABSTRACT FROM AUTHOR]