Internal spermatic vein diameter and age at operation reflect the responseto varicocelectomy

It was evaluated whether the diameter of internal spermatic veins (measured directly during operation) correlates with the clinical grade and treatmen t outcome following varicocelectomy. Fifty-seven consecutive men undergoing left varicocelectomy were included in the study, and spermatic vein diamet er was compared with the response to the operation. The diameter appeared l arger with increasing clinical grade (subclinical: 3.40 +/- 1.64 mm; grade 1: 2.74 +/- 0.84 mm, grade 2: 3.70 +/- 1.09 mm; grade 3: 4.38 +/- 1.30 mm). In patients 30 years or older, spermatic vein diameter in men whose post-o perative semen parameters were unchanged or worsened was statistically larg er than that of patients whose post-operative semen parameters were improve d, in terms of both sperm concentration (3.90 +/- 1.24 mm versus 2.84 +/- 0 .94 mm; P < 0.05) and sperm motility (3.98 +/- 1.24 mm versus 2.67 +/- 0.67 mm, P < 0.01). Although the diameter of internal spermatic veins measured directly during operation correlated well with clinical grade, it is the di ameter and patient's age at operation, but not clinical grade, that determi ne the reversibility of testicular injury following varicocelectomy.