CAUSES OF LOW VISION AND THEIR MANAGEMENT AT KORLE BU TEACHING HOSPITAL, ACCRA, GHANA
*ACKUAKU-DOGBE EM1 , ABAIDOO B1 , BRAIMAH ZI1 , AFENYO G2 , ASIEDU S2
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ABSTRACT
Background: Infertility can be a source of anxiety and marital disharmony to a couple. The male factor traditionally contributes 40%. Varicocoeles are a significant cause of male infertility.
Aim: To assess the effect of varicocoelectomy on seminal fluid analysis parameters in sub-fertile males.
Methodology: This was a prospective study of fifty four patients who presented with infertility to the urology clinic of University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria between January 2015. and January 2016 . Those who had clinically palpable varicocoeles as the only suspected cause of their infertility were enrolled. The varicocoeles were classified into right, left or bilateral and graded into grades 1, 2 and 3 using Dubins criteria. Each patient had two semen analyses done two weeks apart and underwent a bilateral varicocoelectomy via the inguinal approach. Seminal fluid analyses were done post operatively at four and six months.
Results: Of the 54 patients that underwent varicocoelectomy, 11 (20.4%) had azoospermia, 28 (51.9%) had oligospermia and 15 (27.8%) had counts greater than 20 million but less than 40 million. Following varicocoelectomy there was a statistically significant increase in overall motility (p=0.000), morphology (p=0.000), density (p=0.000) and semen volume (p=0.004). Assessing only oligospermic patients there was no significant improvement in morphology (p=0.160). Azoospermic patients showed statistically significant improvement in all parameters though the values were well below those accepted for spontaneous conception.
Conclusion: Varicocoelectomy improves semen parameters in patients with varicocoele induced semen anomalies; it may provide an option for retrieving viable semen for patients with varicocoele induced azoospermia.
Key words:Varicocoeles, Male infertility, Seminal fluid parameters, Varicocoelectomy, Good outcome.
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