The Role of Anogenital Distance Measurement in the Prediction of The Efficacy of Varicocelectomy in Primary Male Infertility
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- Category: Vol. 87, December 2019
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The Role of Anogenital Distance Measurement in the Prediction of The Efficacy of Varicocelectomy in Primary Male Infertility, ABD ELRAHMAN W. BEDAIR, AHMED F. GHAITH, KHALID A. SALEM and AYMAN A. HASSAN
Abstract
Background: Anogenital distance is a marker of genital development and adult testicular function. It is currently difficult to assess which patients are most likely to benefit from varicocelectomy. The present study showed that men with a longer AGD had a higher likelihood of improvement after varicocelectomy. Aim of Study: Is to evaluate the role of Anogenital Distance (AGD) measurement in the prediction of the efficacy of varicocelectomy on the improvement of semen parameters in primary male infertility. Material and Methods: •A prospective study included sixty male patients presented with primary infertility and clinical evident primary varic-ocele with altered semen parameters. •All patients underwent measuring the distance from the posterior aspect of the scrotum to the anal verge in millimeters using a digital caliper. •All patients underwent varicocelectomy (subinguinal ap-proach) by the same experienced surgeon using intraoperative Doppler and magnification loupe. •All patients were followed-up with semen analysis after 6 months of varicocele repair. Results: •Overall, 76.7% of our patients (46 patients) revealed improvement in their semen parameters after 6 months of varicocelectomy, men with longer AGD had better improve-ment in their semen parameters after surgery than men with shorter AGD, 30 patients (88.2%) with AGD >!30mm vs. 16 patients (61.5%) with AGD <30mm. •In patients with AGD >30mm. The sperm concentration increased from 13.5 to 18.8 million sperm per ml (p-value <0.001), the progressive motility (A + B) increased from 27.9% to 39.5% (p-value <0.001), the mean abnormal forms decreased from 57.2% to 36.2% (p-value <0.001). While in the other group with AGD <30mm there was no statistical differences in different semen parameters post-operatively. Conclusions: AGD may provide a novel metric to assess intrinsic testicular function and predict efficacy of varicocele repair.