Correlation Between Semen Quality and Bilateral Scrotal Skin Temperature Shown in the Chronological Results of Two Patients With Left-Sided Varicocele

Scrotal skin temperature (SST) reflects intratesticular temperature, the elevation of which has adverse effects on bilateral spermatogenesis. The present study evaluated the effects of bilateral heat stress on the semen quality of two patients with a left-sided varicocele using chronological SST measurements. Scrotal skin temperature in two patients with a left-sided varicocele was determined using a thermal imaging camera (FLIR C2, FLIR Systems, Wilsonville, OR, USA). Case 1 was a single man seeking preconception care and diagnosed with a painful Grade 2 varicocele. The value for left side SST-right side SST (ΔSST) decreased from 3.2°C to -1.2°C along with the exacerbation of the varicocele from Grade 2 to 3. A varicocelectomy was performed because of the worsening of semen quality. Case 2 was an infertile man with a painful Grade 1 varicocele. The initial ΔSST of 2.4°C was temporarily reduced to 0.6°C, followed by recovery to 2.6°C along with a clear improvement in spermatogram results. To the best of our knowledge, the present chronological findings are the first to show that bilateral elevation of intratesticular temperature in a patient with a left-sided varicocele is substantially related to the deterioration of spermatogenesis.