The current study aims to evaluate the prognostic indicators of testicular fine-needle
aspiration (TFNA) findings on the outcome of varicocele (Vx) surgery.
Patients and methods
The study was a multicentric prospective cohort study carried out in Ibnsina, Sohag
and Banon, Assiut ICSI centers, Egypt. We included all infertile men with
nonobstructive azoospermia diagnosed with grade II bilateral Vx. TFNA was done for
all men, and according to the presence or absence of sperms in TFNA smears they
were divided into two groups: group I, Vx patients with positive TFNA, and group II, Vx
patients with negative TFNA. Next, patients were subjected to inguinal-loupe-assisted
Vx ligation. The primary outcome of the study was the rate of improvement in semen
parameters within 1 year after surgery.
Postoperative semen analyses in both groups revealed that 18/33 (54.5%) patients in
group I versus 10/48 (20.8%) in group II had positive sperms in their ejaculates with
statistically significant difference (P = 0.001). In addition, semen parameters in group I
had significantly higher results than group II. There were significant positive
correlations between the number of recovered sperms by TFNA preoperatively and the
total testicular volume on one hand and postoperative semen parameters on the other
hand (Po0.001), whereas significant negative correlations were found between serum
follicle-stimulating hormone (FSH) and postoperative semen parameters (Po0.001).
Taking prognostic parameters into consideration is important before counseling
nonobstructive azoospermia patients with Vx to undergo varicocelectomy. The findings
of sperms preoperatively through performing TFNA could be a good prognostic
indicator to varicocelectomy.