Pattern of Presentation and Management of Varicocele in a Tertiary Hospital in Northwestern Nigeria

Abstract

Background: Varicocele is the abnormal dilatation of pampiniform venous plexus and internal spermatic vein. It is the commonest surgically correctable cause of male infertility. We reviewed pattern of presentation and management of varicocele in our hospital.
Methodology: This is a retrospective review of 100 patients managed for varicocele in our hospital from January 2011 to August, 2020. Data was collected via a proforma and was analyzed using SPSS version 25.0. The results were reported in percentages, mean ± standard deviation.
Results: The mean age of the patients was 35.2 ± 8.4 years with a range of 17 to 58 years. The varicocele was asymptomatic in 86 patients (86%), it was during evaluation for infertility. There were symptoms in 16 single young patients. The symptoms include scrotal pain and discomfort in 14 patients (14%) each and scrotal swelling in 7 patients (7%). There were co-morbidities in 7 patients (7%). There were abnormal seminal fluid parameters in 75 patients (75%), low testosterone in 23 patients (23%), testicular atrophy and or primary testicular failure in 51 patients (51%). Open sub-inguinal varicocelectomy was done in 67 patients (67%), 60% as day cases. The overall rate of improvement in seminal fluid parameters and pregnancy rates were 68.6 % and 11.9% respectively. There was resolution of symptoms in all the 16 symptomatic cases.
Conclusion: Varicocele is a common cause of infertility in our environment and most patients are discovered during evaluation for infertility. Patients present late with testicular dysfunction with or without primary testicular failure. Varicocelectomy was associated with good symptomatic response, improvement in seminal fluid parameters but low pregnancy rate due to testicular atrophy.