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Urology Annals Jul 2013Historically, idiopathic varicocele is the most commonly diagnosed pre-pubertal andrological condition. The clinical presentation of varicocele may vary from dull and... (Review)
Review
Historically, idiopathic varicocele is the most commonly diagnosed pre-pubertal andrological condition. The clinical presentation of varicocele may vary from dull and dragging unilateral or bilateral testicular pain to visible varicose veins lying over the hemiscrotum. Over the last decade, significant strides were made in managing symptomatic varicoceles, particularly minimal invasive procedures and surgeries. We sought to review the published literature in a systematic manner to gain an overview and streamline the presentations and main treatment modalities.
PubMed: 24049372
DOI: 10.4103/0974-7796.115728 -
Fertility and Sterility Dec 2011To perform a literature search on the association between varicocele and sperm DNA fragmentation. (Review)
Review
OBJECTIVE
To perform a literature search on the association between varicocele and sperm DNA fragmentation.
DESIGN
Systematic review.
PATIENT(S)
Men with a varicocele and infertility.
INTERVENTION(S)
Varicocele repair.
MAIN OUTCOME MEASURE(S)
Does the presence of a varicocele increase seminal oxidative stress and sperm DNA fragmentation?
RESULT(S)
In men with a varicocele increased levels of reactive oxygen species and sperm DNA damage can be found. This is probably related to defective spermatogenesis in these patients. Seminal oxidative stress is believed to be the source of sperm DNA damage. Patients with a varicocele and oligospermia may also have a diminished seminal antioxidant capacity. After varicocele repair sperm DNA fragmentation decreases.
CONCLUSION(S)
Varicocele is associated with sperm DNA damage, and this sperm pathology may be secondary to varicocele-mediated oxidative stress. The beneficial effect of varicocelectomy on sperm DNA damage further supports the premise that varicocele may impair sperm DNA integrity.
Topics: DNA; DNA Damage; DNA Fragmentation; Humans; Infertility, Male; Male; Oxidative Stress; Spermatozoa; Varicocele
PubMed: 22035729
DOI: 10.1016/j.fertnstert.2011.10.016 -
BMJ Clinical Evidence Jan 2009Varicocele is estimated to affect 10-15% of men and adolescent boys. It usually occurs only on the left side, and is often asymptomatic. There is little evidence that... (Review)
Review
INTRODUCTION
Varicocele is estimated to affect 10-15% of men and adolescent boys. It usually occurs only on the left side, and is often asymptomatic. There is little evidence that varicocele reduces male fertility, although it is found in 12% of male partners of couples presenting with infertility, and in 25% of men with abnormal semen analysis.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in men with varicocele? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 11 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: embolisation, expectant management, sclerotherapy, and surgical ligation.
Topics: Humans; Incidence; Infertility, Male; Ligation; Male; Prospective Studies; Sclerotherapy; Semen; Sperm Count; Treatment Outcome; Varicocele
PubMed: 19445764
DOI: No ID Found