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Andrology Nov 2019The correlation between the increased mean platelet volume and varicocele is controversial.
BACKGROUND
The correlation between the increased mean platelet volume and varicocele is controversial.
OBJECTIVES
We designed this research to demonstrate the correlation relationship between varicocele and mean platelet volume by studying the changes of mean platelet volume in patients with varicocele before and after operation.
MATERIALS AND METHODS
A total of 317 patients with left unilateral varicocele underwent operation, and 293 healthy adult males were enrolled in the study. We collected diagnostic data for preoperative patients through physical examination, color Doppler ultrasonography, and blood routine, and recorded the follow-up data at 6 months after operation for varicocele. Platelet indices and the degree of varicocele or the diameter of spermatic vein correlation analysis were performed. Mean platelet volume values of preoperative and 6-month postoperative were statistically evaluated.
RESULTS
We found that the degree of varicocele and the diameter of spermatic vein were positively correlated with mean platelet volume (p = 0.001 or p < 0.001). When the left unilateral varicocele patients and healthy subjects were compared, there was a significant increase in mean platelet volume (p = 0.003). Mean platelet volume values of 96 varicocele patients who were cured by operation for varicocele after 6 months were decreased significantly more than preoperative (p = 0.039), but 32 varicocele patients of 6-month postoperative recurrence could not prove this change (p = 0.930).
DISCUSSION AND CONCLUSION
Our research proves that mean platelet volume was positively correlated with the degree of varicocele and the diameter of spermatic vein and varicocele patients showed significantly higher mean platelet volume than healthy subjects. The mean platelet volume of varicocele patients cured by operation for varicocele after 6 months was lower than before, but there was no difference in mean platelet volume between 6-month postoperative recurrent patients with preoperative.
Topics: Adult; Blood Platelets; Cross-Sectional Studies; Humans; Male; Mean Platelet Volume; Sperm Count; Sperm Motility; Spermatozoa; Ultrasonography, Doppler, Color; Varicocele; Veins; Young Adult
PubMed: 30969016
DOI: 10.1111/andr.12605 -
American Journal of Clinical and... 2020Varicocele is one of the most frequent andrological diseases in adolescents; laparoscopic varicocelectomy is a good option. The aim of this study is to investigate,...
BACKGROUND
Varicocele is one of the most frequent andrological diseases in adolescents; laparoscopic varicocelectomy is a good option. The aim of this study is to investigate, report and evaluate surgical outcomes of laparoscopic technique in pediatric age using percutaneous instruments.
MATERIALS AND METHODS
We report our experience with a new technique for varicocelectomy. I.R.B. approved the study. Patients with varicocele and testicular hypotrophy age between 9 and 16 years underwent laparoscopic varicocelectomy using a single transumbilical port for camera and 2 laparosocpic 2.5 mm percutaneous instruments. After dissection of lymphatic vessels and artery, veins were coagulated using monopolar hook. After the procedure a standard umbilical closure was performed using resorbable stiches, without suture into the percutaneous accesses. All patients underwent 2 controls visit at 3 and 6 months after surgery.
RESULTS
During the study period (April 2018-October 2019) 25 patients were treated; all patients were treated by the same surgeon. There were no cases of recurrence nor hydrocele. All patients reported a good post-op activity without pain and a good cosmetic result.
CONCLUSION
This first small series report a new technique for varicocelectomy; our study demonstrate that this technique is safe without complications and it is associated with good cosmetic results.
PubMed: 32929405
DOI: No ID Found -
Journal of Reproduction & Infertility 2022Varicoceles are a major cause of infertility. The purpose of this study was to determine the relationship of the clinical and ultrasonographic grades of varicocele with...
BACKGROUND
Varicoceles are a major cause of infertility. The purpose of this study was to determine the relationship of the clinical and ultrasonographic grades of varicocele with the semen analysis profile and testicular volume among men undergoing scrotal ultrasonography.
METHODS
This cross-sectional analytical study involved 109 males undergoing scrotal ultrasonography for various indications in Shiraz, Iran, between January 2019 and January 2020. Varicoceles were graded with color Doppler ultrasonography (CDU) by an expert radiologist (Sarteschi's criteria) before an experienced urologist determined the clinical grade (Dubin and Amelar criteria) and requested further investigations. Next, the demographics, reasons for referral, testicular volumes, and semen analysis profiles across the different clinical/ultrasonographic grades were compared. Key statistical measures included Cohen's kappa coefficient, the Mann-Whitney and Kruskal-Wallis tests, and Spearman correlation. Data were analyzed using SPSS v. 21 with p-values <0.05 indicating statistical significance.
RESULTS
Ultrasonographic grades 1 and 2 provided the highest correlation with subclinical cases, while ultrasonographic grades 3, 4, and 5 corresponded with clinical grades 1, 2, and 3, respectively. Further comparisons were made between subclinical and clinical cases, which were similar in terms of reason for referral, total testicular volume, testicular volume differential, and semen analysis profile. Notably, total testicular volumes below 30 were associated with oligoasthenoteratospermia.
CONCLUSION
The present study showed a relatively high correlation between varicocele grading based on clinical evaluation and CDU. However, the grades were similar in testicular volume parameters and semen analysis indices. Hence, decision-making should be guided by the infertility history, testicular atrophy, and abnormal semen analysis.
PubMed: 36043130
DOI: 10.18502/jri.v23i2.8992 -
Faculty Reviews 2020Interest in male infertility has increased, as it plays an important role in up to 50% of couples struggling with infertility, which is an estimated 48.5 million couples... (Review)
Review
Interest in male infertility has increased, as it plays an important role in up to 50% of couples struggling with infertility, which is an estimated 48.5 million couples globally. Despite recent advances, diagnosing and treating male infertility remain a significant clinical challenge owing to complex multifactorial pathways and the diversity of treatment options. This review will assess current controversial topics on male infertility such as the use of home-based semen testing, management of subclinical varicocele, and recent advances in the field of sperm proteomics.
PubMed: 33659954
DOI: 10.12703/r/22 -
Andrology Sep 2021Scrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new-generation ultrasound machines characterized by clearly... (Review)
Review
BACKGROUND
Scrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new-generation ultrasound machines characterized by clearly improved image quality, low health cost, and higher patient safety, represents only some characteristics of ultrasound investigation. The usefulness of scrotal ultrasonography is particularly evident in the period of life from infancy to puberty, during which males undergo important morphofunctional changes, and several pathological conditions may occur.
OBJECTIVES
This pictorial review primarily aimed to investigate the aspects of ultrasonography related to the normal physiological development of the gonads from mini-puberty to pubertal onset. This study also aimed to provide an update on the use of ultrasonography in main andrological pathologies that may occur during this period. The conditions that are discussed in depth are: cryptorchidism, inguinoscrotal hernias, and hydrocele in the neonatal phase; acute scrotum, epididymo-orchitis, and testicular cancers in childhood; and hypogonadism, varicoceles, testicular microlithiasis, and oncohematological pathology in puberty.
DISCUSSION
We provided an ultrasound slant for all the above-mentioned pathologies while purposely avoiding excessive deepening of the pathogenetic, clinical, and therapeutic aspects. Studying the ultrasound aspects of the gonads also facilitates differential diagnosis between various conditions and represents a good aid in evaluating therapeutic success (e.g., in hypogonadism or postsurgical evaluation of varicoceles and cryptorchidism).
CONCLUSION
Scrotal ultrasonography is now globally recognized as the necessary completion of clinical-laboratory overview in gonads evaluation. This diagnostic procedure is even more indispensable in the infancy-childhood-puberty period for the evaluation of normal gonadal development as well as diagnosis of other possible diseases.
Topics: Adolescent; Child; Child, Preschool; Genital Diseases, Male; Humans; Infant; Infant, Newborn; Male; Medical Illustration; Puberty; Scrotum; Ultrasonography
PubMed: 34048149
DOI: 10.1111/andr.13056 -
An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men.Andrology Jan 2020Sperm chromatin integrity is essential for normal embryo development and pregnancy outcome. Sperm DNA fragmentation (SDF) testing constitutes a diagnostic tool to... (Review)
Review
BACKGROUND
Sperm chromatin integrity is essential for normal embryo development and pregnancy outcome. Sperm DNA fragmentation (SDF) testing constitutes a diagnostic tool to measure the proportion of spermatozoa with damaged chromatin in the ejaculate. SDF is associated with potentially treatable conditions, including varicocele, male accessory gland infections, inadequate lifestyle, and gonadotoxin exposure, thus prompting their treatment as a means of improving sperm DNA quality and the reproductive outcomes.
OBJECTIVE
To provide an up-to-date review of the role of clinical and surgical interventions on SDF values in subfertile men.
MATERIALS AND METHODS
An extensive search of studies examining the relationship between male infertility conditions associated with SDF was performed using PubMed and MEDLINE, with a focus on interventional therapy. The start date for the search was not defined, whereas the end date was March 2019. Randomized and non-randomized controlled trials, observational studies, systematic and narrative reviews, and case series were evaluated.
RESULTS
Treating the underlying male infertility factor seems a promising way to alleviate SDF and to increase the likelihood of achieving natural and assisted conception, but data remain limited. The best evidence relates to varicocele repair and hormonal therapy with the follicle-stimulating hormone. Antioxidant therapy and lifestyle changes might alleviate oxidative sperm markers and decrease SDF but their effects on pregnancy outcomes are still unclear. Among men with high SDF undergoing assisted reproductive technology, the use of testicular spermatozoa in preference over ejaculated spermatozoa for intracytoplasmic sperm injection (ICSI) has been shown to improve pregnancy rates possibly owing to the better sperm chromatin quality in testicular spermatozoa than in ejaculated spermatozoa.
CONCLUSION
Current evidence supports interventional therapy as a means to alleviate sperm DNA damage. Identification of the conditions associated with SDF remains important to enable treatment to potentially improve pregnancy outcomes but given the limited data further research is needed to determine the exact role of specific interventional therapy for subfertile men with impaired sperm chromatin.
Topics: Clinical Laboratory Techniques; DNA Fragmentation; Fertility; Genetic Techniques; Humans; Infertility, Male; Male; Spermatozoa
PubMed: 31692293
DOI: 10.1111/andr.12724 -
Translational Andrology and Urology Apr 2024Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the testicular artery, and varicocele recurrence....
Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the testicular artery, and varicocele recurrence. The advantages of the microscopic approach to varicocele repairs are detailed identification and preservation of the vascular structures. In this study, our purpose is to review the outcome of all patients that underwent microscopic subinguinal varicocelectomy with the video telescopic operating microscope (VITOM). Hence, a retrospective review of 23 varicocele patients who underwent microscopic subinguinal varicocelectomy at the center from the year 2019 until 2021 was done. They, ranging between 18 to 58 years of age, comprising one case of right varicocele, fifteen cases of left varicocele, and seven cases of bilateral varicocele, were all having symptoms (pain and swelling) and clinically palpable varicocele. Ultrasounds were done to confirm the diagnosis and measure the testicular size. The surgery was performed by a single surgeon, under spinal anesthesia. The operation was performed using the VITOM telescope system, with an average operative time of one hour. The patients were followed-up at one month postoperatively to review the wound and symptoms. Phone call evaluations of all 23 patients were done to detect any recurrence or complications. All patients were discharged one day after surgery. Post-operative, all of them have a well-formed scar at the previous subinguinal region incision wound during the clinic visits. None of the 23 patients reported with varicocele recurrence, testicular pain, hydrocele formation or sexual dysfunction. The previous testicular pain or discomfort they encountered prior to the surgery was resolved as well. In conclusion, microscopic subinguinal varicocelectomy using the VITOM telescope is feasible and could achieve good outcomes.
PubMed: 38721290
DOI: 10.21037/tau-23-586 -
The World Journal of Men's Health Oct 2022This study provides a comprehensive analysis of research trends on the etiology, mechanisms, potential risk factors, diagnosis, prognosis, surgical and non-surgical...
PURPOSE
This study provides a comprehensive analysis of research trends on the etiology, mechanisms, potential risk factors, diagnosis, prognosis, surgical and non-surgical treatment of varicocele, and clinical outcomes before and after varicocele repair.
MATERIALS AND METHODS
Varicocele studies published between 1988 and 2020 were retrieved from the Scopus database on April 5, 2021. Original studies on human varicocele were included, irrespective of language. Retrieved articles were manually screened for inclusion in various sub-categories. Bibliometric data was subjected to scientometric analysis using descriptive statistics. Network, heat and geographic mapping were generated using relevant software.
RESULTS
In total, 1,943 original human studies on varicocele were published. These were predominantly from the northern hemisphere and developed countries, and published in journals from the United States and Germany. Network map analysis for countries showed several interconnected nodal points, with the USA being the largest, and Agarwal A. from Cleveland Clinic, USA, being a center point of worldwide varicocele research collaborations. Studies of adolescents were underrepresented compared with studies of adults. Studies on diagnostic and prognostic aspects of varicocele were more numerous than studies on varicocele prevalence, mechanistic studies and studies focusing on etiological and risk factors. Varicocele surgery was more investigated than non-surgical approaches. To evaluate the impact of varicocele and its treatment, researchers mainly analyzed basic semen parameters, although markers of seminal oxidative stress are being increasingly investigated in the last decade, while reproductive outcomes such as live birth rate were under-reported in the literature.
CONCLUSIONS
This study analyzes the publication trends in original research on human varicocele spanning over the last three decades. Our analysis emphasizes areas for further exploration to better understand varicocele's impact on men's health and male fertility.
PubMed: 35118839
DOI: 10.5534/wjmh.210202 -
Journal of Reproduction & Infertility 2022Few studies have investigated the relationship of seminal L-Carnitine (LC) with male infertility associated with varicocele. The purpose of this prospective...
BACKGROUND
Few studies have investigated the relationship of seminal L-Carnitine (LC) with male infertility associated with varicocele. The purpose of this prospective cross-sectional study was to assess seminal plasma LC levels in infertile oligoathenoteratozoospermic (OAT) men with varicocele.
METHODS
Overall, 86 men were investigated. They were divided into infertile OAT men with varicocele (n=45), infertile OAT men without varicocele (n=21), and fertile men (n=20) as a control group. According to WHO guidelines, these men were subjected to history taking, clinical examination, and semen analysis. Seminal LC levels were evaluated by the colorimetric method. Statistical comparisons were done using Kruskal-Wallis and Mann-Whitney U tests and correlations were verified by the Pearson test. P-value<0.05 was set to be statistically significant.
RESULTS
The mean seminal plasma LC levels were significantly lower in infertile OAT men with varicocele (216.3±57.1 ) compared to infertile OAT men without varicocele (252.9±62.9 , p=0.01), or fertile men (382.8±63.6 , p=0.001). Besides, the mean seminal plasma LC level exhibited statistically significant decreases in infertile OAT men of varicocele grade III compared to varicocele grade II cases, and in infertile OAT men with bilateral varicocele compared with unilateral varicocele cases. Collectively, there was a statistically significant positive correlation between seminal LC levels with sperm concentration, motility, and normal morphology.
CONCLUSION
Seminal LC levels are expressively reduced in infertile OAT men with varicocele and are influenced by an increase in varicocele grade and laterality.
PubMed: 36045882
DOI: 10.18502/jri.v23i1.8449 -
Asian Journal of Andrology Apr 2023The mechanisms of testicular development in mammals are complex. Testis is an organ that produces sperm and secretes androgens. It is rich in exosomes and cytokines that...
The mechanisms of testicular development in mammals are complex. Testis is an organ that produces sperm and secretes androgens. It is rich in exosomes and cytokines that mediate signal transduction between tubule germ cells and distal cells, promoting testicular development and spermatogenesis. Exosomes are nanoscale extracellular vesicles that transmit information between cells. By transmitting information, exosomes play an important role in male infertility diseases such as azoospermia, varicocele, and testicular torsion. However, due to the wide range of sources of exosomes, extraction methods are numerous and complex. Therefore, there are many difficulties in studying the mechanisms of exosomal effects on normal development and male infertility. Therefore, in this review, first, we introduce the formation of exosomes and methods for culturing testis and sperm. Then, we introduce the effects of exosomes on different stages of testicular development. Finally, we summarize the prospects and shortcomings of exosomes when used in clinical applications. We lay the theoretical foundation for the mechanism of the influence of exosomes on normal development and male infertility.
PubMed: 37040218
DOI: 10.4103/aja2022126