Significant reduction in left testicular volume shown by ultrasonography in infertile patients with left‐side grade 2–3 varicocele as compared to less than grade 2: An evidence for indication of varicocelectomy

Purpose Testicular volume (TV) is known to be one of the main parameters for testicular function (TF). This study was conducted to re‐evaluate the indications of a varicocelectomy based on a survey of preoperative TV results in left‐side varicocele patients considered to reflect the detrimental effects of a varicocele on TF. Methods TV results of infertile patients determined using ultrasonography by a single expert physician were retrospectively evaluated. Results Of 590 examined patients, 424 had no varicocele findings (Group A), while 148 had a left‐side varicocele (Group B). Group B was subdivided based on varicocele grade into Group B0 (subclinical), B1 (grade 1), B2 (grade 2), and B3 (grade 3). Comparisons of left‐side TV showed no significant differences for grade among Group A, B0, and B1, whereas that for Group B2 and B3 was significantly lower as compared with Group A ( p < 0.01, 0.02, respectively). The median TV of Group B I (composed of Groups B0 and B1) was 9.8 cm 3 , while that of Group B II (Groups B2 and B3) was significantly lower at 8.4 cm 3 ( p < 0.05). In contrast, a comparison of right TV values identified no significant differences among the groups ( p = 0.918). Conclusion A varicocelectomy should be performed for patients with a grade 2 and 3 varicocele for ameliorating testicular function.