The patients were not included in the study if any of the following conditions were present: history of varicocelectomy, surgery for undes-cended testes (UDT), testicular torsion/
detortion (by operation or spontaneously), testicular biopsy, sexually transmitted diseases, testicular cancer, vasectomy, testcular trauma, history of anal sex, inguinal hernioraphy, immunosuppressed patients, use of immunosuppressive drugs, such as steroids or cytotoxic and chemopreventive drugs, and malnutrition.
In third trimester, it is technically difficult to operate in the pelvis due to large gravid uterus acting as a mechanical impediment to
detortion. When surgical intervention is required, a standard midline incision allows maximum exposure with minimal uterine manipulation.