Intratesticular Artery Resistive Index Changes After Varicocelectomy

NCT07517952 | Not Yet Recruiting

• 1 other identifier: Changes after Varicocelectomy
• Study Type: interventional
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to evaluate how blood flow inside the testicles changes after surgery to correct a varicocele, and whether these changes correlate with improvements in semen quality and testosterone levels. Varicocele is a common, treatable cause of male infertility that can negatively affect testicular function by altering blood flow and temperature. While surgery (varicocelectomy) often improves fertility, doctors are continually looking for ways to predict which patients will benefit the most from the procedure. This study uses scrotal color Doppler ultrasound to measure the Intratesticular Artery Resistive Index (RI), which is an indicator of blood flow resistance and microvascular health, before and after surgery. Researchers will recruit 40 infertile men with clinically palpable varicoceles. Participants will undergo a baseline evaluation that includes a physical exam, semen analysis, a blood test for total testosterone, and a specialized ultrasound to measure the RI under different physical conditions (lying down, standing, and during a Valsalva maneuver/bearing down). All participants will then undergo a microscopic sub-inguinal varicocelectomy, which is the standard microsurgical treatment. Three months after the surgery, participants will return for follow-up testing to repeat the semen analysis, testosterone blood test, and ultrasound. The main goal of the study is to determine if pre-operative RI measurements can serve as an early, reliable predictor of surgical success, specifically looking at the recovery of testicular function, sperm parameters, and hormonal levels.

Conditions

Male Infertility; Secondary Hypogonadism; Varicocele

Keywords

Varicocelectomy; Resistive Index; Intratesticular Artery; Semen Parameters; Testosterone; Color Doppler Ultrasonography; Microscopic Sub-inguinal Varicocelectomy

Outcome Measures

Primary Outcomes (1)

• Change in Intratesticular Artery Resistive Index (RI)

  The Intratesticular Artery Resistive Index (RI) is assessed using scrotal color Doppler ultrasonography. It is calculated from the peak systolic and end-diastolic velocities of the intratesticular and capsular arteries to evaluate testicular parenchymal microperfusion and vascular impedance. Measurements are taken under standardized physiological conditions.

  Baseline (pre-operative) and 3 months post-operatively.

Study Arms (1)

Microscopic Sub-inguinal Varicocelectomy

EXPERIMENTAL

Participants in this single-arm study consist of infertile male patients with clinically palpable varicocele (Grades I to III). All participants assigned to this arm will undergo the study intervention, which is a microscopic sub-inguinal varicocelectomy. The surgical procedure involves a sub-inguinal incision and the use of an operating microscope to carefully isolate the spermatic cord and ligate all internal spermatic veins while preserving the testicular artery, vas deferens, and lymphatic vessels.

Procedure: Microscopic Sub-inguinal Varicocelectomy

Interventions

Microscopic Sub-inguinal Varicocelectomy PROCEDURE

The procedure involves making a sub-inguinal incision just below the external inguinal ring. Using an operating microscope, the spermatic cord is carefully isolated and systematically dissected. All internal spermatic veins are identified and ligated. Meticulous care is taken to preserve the testicular artery and its branches, the cremasteric artery, the vasal artery, the vas deferens, and lymphatic vessels to minimize the risk of post-operative complications such as hydrocele formation.

Microscopic Sub-inguinal Varicocelectomy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Infertile male patients with clinically palpable varicocele (Grade I to III).

You may not qualify if:

• Extremes of age (pediatric or geriatric populations).
• History of previous scrotal surgery or trauma.
• Active urogenital infection (e.g., epididymo-orchitis).
• History of testicular torsion.
• Any comorbidity that may independently affect testicular vascularity or hemodynamics.

Sponsors & Collaborators

• Assiut University: lead

MeSH Terms

Conditions

Varicocele; Infertility, Male; Hypogonadism

Condition Hierarchy (Ancestors)

Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Male Urogenital Diseases; Vascular Diseases; Cardiovascular Diseases; Infertility; Gonadal Disorders; Endocrine System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident at Andrology, Sexology and STDs Department, Assiut University

Study Record Dates

• First Submitted: April 2, 2026
• First Posted: April 8, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: April 8, 2026

Record last verified: 2026-04