TITLE:
Adult Varicocele in Burkina Faso: A 10-Year Retrospective Multicenter Study of Clinical Features and Surgical Outcomes
AUTHORS:
Brahima Kirakoya, Wendinmi Hilaire Sylver Sawadogo, Ouima Justin Dieudonné Ziba, Yannick Jean Rodrigue Pingdwende Traoré, Hassami Sawadogo, Abdoul Karim Paré, Abdoul Karim Ouattara, Clotaire Alexis Marie Kiemdiba Donega Yaméogo, Fasnewinde Aristide Kaboré
KEYWORDS:
Varicocele, Male Infertility, Semen Analysis, Varicocelectomy, Sub-Saharan Africa, Burkina Faso
JOURNAL NAME:
Open Journal of Urology,
Vol.16 No.9,
September
23,
2026
ABSTRACT: Background: Varicocele is the most common surgically correctable cause of male infertility, yet data from sub-Saharan Africa remain scarce. Methods: We conducted a retrospective, two-center cohort study, with a nested paired-comparison analysis of pre- and postoperative semen parameters in the subgroup with available follow-up data, at two urology referral centers in Burkina Faso between 1 June 2015 and 30 May 2025. All men aged 18 years or older diagnosed with varicocele by clinical examination, confirmed by scrotal Doppler ultrasonography, were eligible; men with secondary varicocele, an unusable clinical record, or age over 65 years were excluded. Results: Of 537 varicocele cases identified, 503 were analyzed (CHU-SS, n = 196; CHU-YO, n = 307); the annual caseload rose from 15 in 2015 to 78 in 2025. Mean age was 35.3 ± 6.1 years. Couple hypofertility was the presenting complaint in 94.0% of patients (primary in 64.8%, secondary in 29.2%), with a mean reported duration of 55.5 ± 41.8 months. Varicocele was bilateral on clinical examination, confirmed by Doppler ultrasonography, in 93.2% of patients and grade II or III in 98.0%. Preoperative semen analysis showed asthenozoospermia in 84.7%, necrozoospermia in 83.7%, teratozoospermia in 64.8%, and severe count abnormalities in most patients (75.4% azoospermic). Higher varicocele grade was associated with reduced progressive motility (p = 0.002) and reduced vitality (p = 0.04) but not with semen volume (p = 0.64) or sperm morphology (p = 0.52). All patients underwent surgical repair; the immediate complication rate was 1.8%. Among the 104 patients (20.7%) with a postoperative semen analysis at a mean of 3 months, progressive motility improved significantly (+12.0 percentage points, p Conclusions: Varicocele is a frequent, often bilateral, and late-presenting condition among infertile men attending Burkina Faso’s two largest urology referral centers, and surgical repair was associated with a significant improvement in sperm progressive motility in the minority of patients with postoperative follow-up. These findings support earlier referral pathways for couple infertility and systematic postoperative semen follow-up to better document the fertility benefit of varicocelectomy.