الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Varicocele repair has been advocated as an option to prevent and treat low serum testosterone, even in men with normal semen quality. The association between clinical varicocele and impaired testosterone production is less clearly understood.Although the conceptions of the negative impact of clinical varicocele on Leydig cell functions and the beneficial effect of varicocele repair on testosterone production have been proposed for decades. Objective: To examine the hypotheses that clinical varicoceles affect baseline serum total testosterone levels and semen analysis in infertile patients who suffer from primary varicocele. The effect of varicocelectomy on serum testosterone levels and semen quality will be studied . Patients and Methods: This study included 110 patients (50 control and 60 cases) presented to the General Surgery and Endocrine Surgery Unit Outpatient Clinic at Mansoura University Hospitals with clinical varicocele for primary infertility. Both groups did not take medications known to elicit imbalance androgen levels. All patients were radiologically evaluated using duplex scrotal ultrasound, semen analysis and serum total testosterone before surgery and 3-6 months post-surgery. The results of both were compared to the postoperative. Results: Regarding preoperative and postoperative testosterone level among the intervention group, there were highly statistically significant increases in total testosterone as well as significant improvement in gonadal functions (significant increase in number of cases with euogonadism) after the operation among the intervention group (P<0.001), however the percent of improvement was more than among hypogonadal compared to euogonadal. Conclusion: Varicocelectomy was demonstrated to significantly improve both sperm quality (in terms of count, motility and morphology) as well as serum testosterone in infertile men, especially in cases with hypogonadism. Varicocelectomy achieved statistically significant improvements of spontaneous pregnancy rate in infertile men who suffer from varicocele.