Study shows negative impact of smoking on outcomes of varicocelectomy

A varicocelectomy is a surgical procedure for varicocele treatment. It can lower testicular pain and can increase male fertility. Risks include bruising, swelling and injury to the testicular artery. Most people fully recover from a varicocelectomy within six weeks.

Previous studies have shown that in men with varicocele, a major cause of male infertility, smoking is associated with decreased sperm functional integrity, altered semen quality, and seminal oxidative stress

Tugay Aksakalli, Erzurum Regional Training and Research Hospital, Erzurum, Turkey, and colleagues aimed to evaluate the effects of smoking on semen parameters and spontaneous pregnancy development by comparing smoker and non-smoker varicocelectomy patients. The study included 63 male patients with primary infertility for at least one year who underwent microscopic subinguinal varicocelectomy at the Erzurum City Hospital urology clinic between 2020 and 2023.

The researchers retrospectively evaluated the patient files, 27 patients were assigned to the smoker group, whereas 36 patients were assigned to the non-smoker group. Semen parameters, demographic data, spontaneous pregnancy development and timing were compared between the two groups.

Based on the study, the following inferences were drawn:

· No statistically significant differences were observed in age, partner's age, BMI, clinical presentation, varicocele grade, side of varicocele, testicular volume, or testicular vein diameters. The mean age of the study group was determined to be 30.7 ± 4.9 years.

· In the non-smoker group, 75% of patients had only subfertility complaints, while 25% of patients also experienced scrotal pain.

· Progressive motility was significantly higher in the non-smoker group in the 3rd month (28.11 ± 5.78 vs. 24.51 ± 4.24) and 6th month (29.61 ± 5.16 vs. 26.22 ± 4.14) evaluations.

· When comparing the rates of pregnancy development, the non-smoker group was determined to have a higher rate (53%), but this comparison was not statistically significant.

· Regarding the timing of pregnancy, the non-smoker group was associated with earlier spontaneous pregnancy. (5.84 ± 2.26 vs. 9.20 ± 2.30).

"Smoking negatively affects the outcomes of varicocelectomy in terms of spontaneous pregnancy development, timing, and semen parameters," the researchers wrote.

"There is a need for prospective, randomized, and larger sample-sized studies on this subject," they concluded.

Reference:

Aksakalli, T., Utlu, A., Demirdogen, S.O. et al. Effects of smoking on varicocelectomy outcomes: a retrospective cohort study. Int Urol Nephrol 56, 415–421 (2024). https://doi.org/10.1007/s11255-023-03816-6