Evaluate the effect of recent ejaculation on scrotal duplex parameters in infertile males with varicocele

Varicocele is abnormal dilatation of the pampiniform plexus veins draining the testicles.

It manifests as an abnormal retrograde flow in the internal spermatic venous system or dilation of venous branches in the external cremasteric system .

It affects approximately 15% in the general population, 35 - 40% in men with primary infertility and approximately 80% of men with secondary infertility. It could often concomitantly occur with infertility or chronic scrotal pain causing impaired spermatogenesis and is the most common correctable cause of male infertility. it may affects spermatogenesis via different mechanisms such as increased testicular heat, hormonal disorders and reflux of toxic metabolites.

Scrotal colour Doppler ultrasonography (USG) is a widely used method for evaluation of varicocele patients . It can be used along with physical examination in these patients through evaluation of vein reflux and diameter; in cases where palpation may be problematic. Furthermore, the degree of reflux and vein diameter can be used during the decision-making stage while treating varicocele .

Ejaculation is the process by which sperms move from epididymis via vas deferens to urethra and finally expelled out through the urethral meatus by the contraction of smooth muscles. A normal antegrade ejaculation consists of emission, expulsion (ejection), and orgasm .

In the evaluation of infertile patients, semen analysis is required for evaluation of number, motility and morphology of spermatozoa with scrotal colour Doppler USG. Ejaculation for the purpose of sperm analysis is known to significantly increase testicular blood supply .

Inclusion Criteria:

1. Infertile male patients.
2. patients with scrotal varicocele.
3. male patients aging over 18 years old.

Exclusion Criteria:

1. Pyospermia.
2. Epididymitis.
3. Orchitis.
4. Anejaculation.
5. Recurrent varicocele.
6. Patients who previously underwent scrotal or inguinal surgery.

Effect of Recent( Ejaculation) on Scrotal Duplex Parameters in Infertile( Males) With Varicocele

Infertile male patients with scrotal varicocele aging over 18 years old.