The dissertation abstract by Yuldashev Jasur Mansurovich, submitted for the degree of Doctor of Philosophy (PhD) in Medical Sciences, examines reproductive disorders associated with varicocele, the effectiveness of microsurgical varicocelectomy in treating male infertility, and the possibilities of achieving natural pregnancy following surgical intervention.
Male infertility is one of the significant challenges in modern medicine. Varicocele is among the important factors contributing to its development, as it may negatively affect spermatogenesis and lead to impaired reproductive function. Therefore, timely diagnosis and the selection of effective surgical treatment methods are essential.
The primary aim of the study was to evaluate the effectiveness of inguinal microsurgical varicocelectomy and improve treatment outcomes by examining natural pregnancy rates in couples affected by male infertility associated with varicocele.
The study analyzed the outcomes of transinguinal microsurgical varicocelectomy performed in 2,871 male patients with varicocele-associated infertility at the Republican Specialized Scientific and Practical Medical Center of Urology between 2005 and 2012.
The study demonstrated that ultrasound examination with Doppler imaging of testicular vessels provides greater diagnostic accuracy than visual and palpatory examination in detecting grade I, right-sided, and bilateral varicocele.
It was also established that changes in ejaculate parameters do not have a consistent direct relationship with primary or secondary infertility, unilateral or bilateral varicocele, or the clinical grade of the condition.
The study revealed that the likelihood of achieving natural pregnancy following microsurgical varicocelectomy varies depending on the type of infertility and the characteristics of the surgical procedure.
According to the study results, the pregnancy rate following varicocelectomy was 74.6% among couples with secondary infertility, compared with 31.9% among couples with primary infertility.
The pregnancy rate following unilateral varicocelectomy was 35.5%, while the rate following bilateral surgery was 46.5%. However, the difference between these groups was not statistically significant.
The median time to pregnancy following surgery was 4 months. The recurrence rate of varicocele after primary surgical interventions was 0.46%. No cases of hydrocele causing patient discomfort were recorded.
The research findings substantiate the importance of using ultrasound examination with Doppler imaging of testicular vessels in the diagnosis of male infertility. This approach enables more accurate detection of certain forms of varicocele and timely selection of appropriate treatment strategies.
Due to its low recurrence rate and favorable clinical outcomes, transinguinal microsurgical varicocelectomy represents an important approach in the surgical treatment of male infertility.
The research findings have been implemented in the clinical practice of the Fergana and Khorezm branches of the Republican Specialized Scientific and Practical Medical Center of Urology.
Researcher: Jasur Mansurovich Yuldashev.
Scientific Supervisor: Shukhrat Tursunovich Mukhtarov, Doctor of Medical Sciences, Professor.
Official Opponents: Asilbek Asadovich Gaybullayev and Fayzulla Yuldashevich Yuldashev.
Leading Institution: Andijan State Medical University.
Specialty: 14.00.31 — Urology.
Institution where the dissertation was conducted: Tashkent State Medical University.