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JAMA Jun 2020
Topics: Embolization, Therapeutic; Humans; Infertility, Male; Male; Varicocele
PubMed: 32484535
DOI: 10.1001/jama.2020.0397 -
Ugeskrift For Laeger May 2020In this review, we discuss varicocele testis, which is found in 15% of men from the general population, but more frequently in infertile populations. It can cause... (Review)
Review
In this review, we discuss varicocele testis, which is found in 15% of men from the general population, but more frequently in infertile populations. It can cause physical symptoms or impaired fertility. Varicocele severity is graded 1-3 by clinical examination, and increasing grade is associated with poorer semen quality. Treatment effect on symptoms and fertility has been documented. A microsurgical approach seems to have the best outcome in terms of lowest frequency of recurrence and complication. Treatment of this common condition is recommended only in patients with symptoms or evidence of affected testicular function.
Topics: Fertility; Humans; Infertility; Male; Semen Analysis; Testis; Varicocele
PubMed: 32400385
DOI: No ID Found -
Seminars in Cell & Developmental Biology Jan 2022Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a... (Review)
Review
Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a proportion of men with varicoceles can suffer from infertility and testosterone deficiency. Sperm and testosterone are produced within the testis, and any alteration to the testicular environment can negatively affect the cells responsible for these processes. The negative impact of varicoceles on testicular function occurs mainly due to increased oxidative stress within the testicular parenchyma which is thought to be caused by scrotal hyperthermia, testicular hypoxia, and blood-testis barrier disruption. Management of varicoceles involves ligation or percutaneous embolization of the dilated veins. Repair of varicoceles can improve semen parameters and fertility, along with serum testosterone concentration. In this review, we discuss the pathophysiology of varicoceles, their impact on testicular function, and management.
Topics: Humans; Infertility, Male; Male; Spermatogenesis; Testosterone; Varicocele
PubMed: 33965333
DOI: 10.1016/j.semcdb.2021.04.005 -
Human Fertility (Cambridge, England) Apr 2021
Topics: Humans; Male; Varicocele
PubMed: 33886415
DOI: 10.1080/14647273.2021.1916145 -
Andrologia Mar 2021The updated systematic review and meta-analysis was conducted to assess the platelet indices between patients with varicocele and healthy subject. The main purpose of... (Meta-Analysis)
Meta-Analysis Review
The updated systematic review and meta-analysis was conducted to assess the platelet indices between patients with varicocele and healthy subject. The main purpose of our study was to explore the relationship between platelet and the pathogenesis of varicocele. Databases including Cochrane Library, PubMed, and MEDLINE were retrieved to identify studies. Two independent investigators extracted the related information of the included original passages. In order to estimate the difference of varicocele patients and healthy subjects, we applied the standardised mean difference (SMD) and the corresponding 95% confidence intervals (95% CIs). 1,156 patients and 797 healthy subjects of nine studies met the pre-set inclusion criteria. The estimated SMD in MPV between varicocele patients and healthy subjects was 0.61 (95% CI: 0.29-0.93, p < 0.001). The estimated SMD in MPV between preoperative varicocele patients and post-operative varicocele patients was 0.22 (95% CI: 0.03-0.41, p = 0.02). The estimated SMD in PLT between varicocele patients and healthy subjects was -0.19 (95% CI: -0.28, -0.08, p = 0.001). The available data suggest that a higher MPV level in varicocele patients, and the varicocele operation can normalise the preoperatively elevated mean platelet volume levels. Further researches are needed to investigate the potential role of platelet with varicocele.
Topics: Blood Platelets; Humans; Male; Mean Platelet Volume; Platelet Count; Postoperative Period; Varicocele
PubMed: 33369777
DOI: 10.1111/and.13939 -
International Braz J Urol : Official... 2023
Topics: Male; Humans; Varicocele; Infertility, Male
PubMed: 37267621
DOI: 10.1590/S1677-5538.IBJU.2023.04.06 -
American Journal of Reproductive... Apr 2022Varicocele is recognized as one of the main attributable causes of male infertility which can affect spermatogenesis by various pathophysiological mechanisms. Recent... (Review)
Review
Varicocele is recognized as one of the main attributable causes of male infertility which can affect spermatogenesis by various pathophysiological mechanisms. Recent studies have identified oxidative stress and reduction in antioxidant, hyperthermia, hypoxia, hormonal dysfunction, and inflammatory conditions as major factors in the pathophysiology of varicocele, all of which have known direct associations with the coronavirus disease 2019 (COVID-19) and can significantly increase the risk of detrimental COVID-19-related outcomes. Emerging data have shown an association between COVID-19 and inflammation, overproduction of cytokine, and other pathophysiological processes. The present review, summarizes the current understanding of the pathophysiology of varicocele and investigates the potential correlation between the severity of COVID-19 and the varicocele disease. In addition, various possible treatments which can be effective in both diseases were examined. Despite numerous challenges associated with the prevalence of COVID-19 in healthcare systems in infected countries, special attention should be given to maintaining a high level of care for complex patients with a pre-existing disease such as varicocele and providing appropriate practical advice for optimal control of the COVID-19 disease.
Topics: COVID-19; Humans; Infertility, Male; Male; Oxidative Stress; Spermatogenesis; Varicocele
PubMed: 34967487
DOI: 10.1111/aji.13518 -
Andrology Sep 2021Varicocoeles have been considered for a long time potentially correctable causes for male infertility, even though the correlation of this condition with infertility and... (Review)
Review
BACKGROUND
Varicocoeles have been considered for a long time potentially correctable causes for male infertility, even though the correlation of this condition with infertility and sperm damage is still debated.
OBJECTIVE
To present a summary of the evidence evaluation for imaging varicocoeles, to underline the need for a standardized examination technique and for a unique classification, and to focus on pitfalls in image interpretation.
METHODS
Based on the evidence of the literature, the current role of ultrasound (US) imaging for varicocoeles has been reported and illustrated, with emphasis on examination technique, classification, and pitfalls.
RESULTS
US is the imaging modality of choice. It is widely used in Europe, while in other countries clinical classification of varicocoeles is considered sufficient to manage the patient. A number of US classifications exist for varicocoeles, in which the examinnation is performed in different ways.
DISCUSSION
An effort toward standardization is mandatory, since lack of standardization contributes to the confusion of the available literature, and has a negative impact on the understanding of the role itself of imaging in patients with varicocoeles.
CONCLUSION
Use of the Sarteschi/Liguori classification for varicocoeles is recommended, since it is the most complete and widely used US scoring system available today. Tubular extratesticular structures resembling varicocoeles, either at palpation or at US, should be identified and correctly characterized.
Topics: Humans; Infertility, Male; Male; Ultrasonography; Varicocele
PubMed: 34038625
DOI: 10.1111/andr.13053 -
The Urologic Clinics of North America Feb 2021The robotic platform offers theoretical and practical advantages to microsurgical male infertility surgery. These include reduction or elimination of tremor,... (Review)
Review
The robotic platform offers theoretical and practical advantages to microsurgical male infertility surgery. These include reduction or elimination of tremor, 3-dimensional visualization, and decreased need for skilled surgical assistance. This article reviews the application of robotic surgery to each of the 4 primary male infertility procedures: vasectomy reversal, varicocelectomy, testicular sperm extraction, and spermatic cord denervation. Historical perspective is presented alongside the available outcomes data, which are limited in most cases. Before the robotic approach can be widely adopted, further clinical trials are needed to compare outcomes and costs with those of other validated surgical techniques.
Topics: Azoospermia; Denervation; Forecasting; Humans; Infertility, Male; Male; Microsurgery; Robotic Surgical Procedures; Spermatic Cord; Testis; Varicocele; Vasovasostomy
PubMed: 33218587
DOI: 10.1016/j.ucl.2020.09.009 -
Journal of Pediatric Urology Feb 2021Varicocele is one of the most frequent disease affecting the fertility potential; OBJECTIVE: the aim of this study is to assess the correlation between clinical and...
INTRODUCTION
Varicocele is one of the most frequent disease affecting the fertility potential; OBJECTIVE: the aim of this study is to assess the correlation between clinical and radiological grade of varicocele and hormonal values.
STUDY DESIGN
The data about adolescents with left unilateral varicocele aged between 13 and 16 years, with Tanner stage V, followed at the Authors' Institution between September 2016 and September 2019 were investigated; inclusion and exclusion criteria were created. Patients underwent standard visit, Ultrasound, Doppler velocimetry and hormonal tests (at T0 and T1). Those patients with testicular hypotrophy underwent surgery.
RESULTS
During the study period, 75 subjects with left unilateral varicocele were enrolled; 8 patients were excluded.A total of 67 patients were then studied. Among these patients, 37 had testicular hypotrophy, while the others had normal testicular volume. There was no correlation between grade of varicocele and testicular hypotrophy (p = 0.12); among those patients with testicular hypotrophy, there was a statistical correlation with the grade of spermatic vein reflux (grade 4 vs grades 1-2-3) (p = 0.03). Focusing on hormonal values, there was a statistical significant difference between FSH levels, clinical grades of varicocele and grade of spermatic vein reflux: FSH levels were higher in patients with clinical grade 3 varicocele respect to patients with grade 1-2 varicocele and, in particular, patients with grade 3 varicocele, testicular hypotrophy and grade 4 spermatic vein reflux (14 patients) had higher FSH level respect to others (p = 0.02). After surgery there was a significant FSH reduction.
CONCLUSIONS
Our results demonstrate that higher grade of spermatic vein reflux is associated with testicular hypotrophy and higher FSH levels.
Topics: Adolescent; Fertility; Humans; Male; Testicular Diseases; Testis; Ultrasonography; Varicocele
PubMed: 33281047
DOI: 10.1016/j.jpurol.2020.11.024