Varicocele: in Search of a Human Model

Aims: To study the effects of left gonadal vein ligation on semen parameters and venous hemodynamics of the testis. Subjects and Methods: All male voluntary kidney donors who were scheduled to have left donor nephrectomy between March 2004 and February 2005, by either open or laparoscopic technique, were considered for this study. Results: A total of 95 live related renal transplants were performed. Left donor nephrectomy was performed in 22 of 37 males. Only 19 were evaluable; 7 patients underwent laparoscopic donor nephrectomy; 6 were unmarried. We observed that 66% (12) of our study patients showed radiological evidence of varicocele, and this was statistically significant; 22% (4) also developed contralateral varicocele; 44% (8) developed oligoasthenozoospermia. Conclusion: Ligation of the left gonadal vein is part of organ harvesting for live related renal transplantation and produces radiologically confirmed varicocele in some men. In these men, alterations in semen parameters are observed over 4–24 weeks. Due to short follow-up, we are unable to state if this is a permanent or temporary effect. We presume that since these men had normal semen parameters earlier, the stress pattern would revert to normal. If it does not however, this would have particular implications upon informed consent for unmarried male donors.