MP43-16: Varicocele induced Testicular hyperthermia: infrared digital thermographic assessment exploring the effect of surgical varicocele correction on postoperative testicular temperature and reproductive outcome.
Introduction: Testicular hyperthermia is considered as one of the main pathophysiological mechanisms of spermatogenic dysfunction in patients with varicocele. The aim is to compare scrotal & inguinal temperature measurements between varicocele patients and normal controls linking such measurements with semen parameters, in addition to the evaluation of changes in such variables after varicocele repair. Methods: Patients with clinical varicocele were included. They were classified into normal semen (group I; n=25); & abnormal semen (group II; n=34). Controls (group III; n=30 ) with no varicocele & normal semen parameters were recruited. Initial conventional semen analysis (WHO 2010) and oxidation reduction potential (ORP) test (MiOXSYS) were performed. Bilateral inguinoscrotal infrared digital thermographic imaging (FLIR E6, Wilsonville, USA) was done. 21 patients from group II underwent microsurgical varicocelectomy, temperature measurements & semen analysis were repeated 3 months post-surgery. Temperature were compared between all groups using ANOVA. Paired t-test was used to evaluate changes in temperature & semen parameters after the procedure. Pearson’s correlations were used to explore the association between temperature measurements & different variables and between changes in post-operative temperature with the changes in semen parameters. Results: Bilateral scrotal temperatures, ORP and semen DNA fragmentation were significantly higher in group II compared with the other 2 groups. Left scrotal temperature was significantly negatively correlated with sperm concentration (-0.268, p=0.004), total motility (-0.337, p<0.001), normal morphology (-0.282, p=0.003) & left testicular size (-0.292, p=0.002). While it was significantly positively correlated with ORP (0.374, p=0.01). After varicocelectomy, there was a significant decrease in bilateral testicular temperature (P = 0.01), and a significant increase in the sperm count (P= 0.03) & Normal morphology (P= <0.001), however, no significant correlation was identified between changes in testicular temperature & changes in all semen parameters. Conclusions: Increased scrotal temperature is detected in patients with testicular dysfunction secondary to clinical varicocele. Varicocele repair results in improvements in testicular temperature & semen parameters. Further studies with larger samples are needed to support correlations between post-operative outcomes. SOURCE OF Funding: none
