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Fertility and Sterility Sep 2017Varicoceles, a dilation of veins within the pampiniform plexus, are present in ∼15% of the general male population. This paper reviews the indications for treatment of... (Review)
Review
Varicoceles, a dilation of veins within the pampiniform plexus, are present in ∼15% of the general male population. This paper reviews the indications for treatment of varicoceles, post-intervention outcomes following treatment, and the various techniques for treatment of varicoceles. The aim of this review is to describe and compare complications associated with each approach to varicocele treatment.
Topics: Combined Modality Therapy; Embolization, Therapeutic; Evidence-Based Medicine; Humans; Infertility, Male; Laparoscopy; Male; Treatment Outcome; Urogenital Surgical Procedures; Varicocele; Vascular Surgical Procedures
PubMed: 28865535
DOI: 10.1016/j.fertnstert.2017.07.020 -
Frontiers in Immunology 2021Varicocele (VC) is present in 35 - 40% of men with infertility. However, current surgical and antioxidant treatments are not completely effective. In addition to... (Review)
Review
BACKGROUND
Varicocele (VC) is present in 35 - 40% of men with infertility. However, current surgical and antioxidant treatments are not completely effective. In addition to oxidative stress, it is likely that other factors such as testicular immune microenvironment disorder contribute to irreversible testicular. Evidence suggests that VC is associated with anti-sperm antibodies (ASAs), spermatogenesis and testosterone secretion abnormalities, and testicular cytokine production. Moreover, inhibition of inflammation can alleviate VC-mediated pathogenesis. The normal function of the testis depends on its immune tolerance mechanism. Testicular immune regulation is complex, and many infectious or non-infectious diseases may damage this precision system.
RESULTS
The testicular immune microenvironment is composed of common immune cells and other cells involved in testicular immunity. The former includes testicular macrophages, T cells, dendritic cells (DCs), and mast cells, whereas the latter include Leydig cells and Sertoli cells (SCs). In animal models and in patients with VC, most studies have revealed an abnormal increase in the levels of ASAs and pro-inflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-alpha in the seminal plasma, testicular tissue, and even peripheral blood. It is also involved in the activation of potential inflammatory pathways, such as the nucleotide-binding oligomerization domain-like receptor family pyrin domain containing (NLRP)-3 pathway. Finally, the development of VC-mediated infertility (VMI) may be facilitated by abnormal permeability of proteins, such as claudin-11, that constitute the blood-testis barrier (BTB).
CONCLUSIONS
The testicular immune response, including the production of ASAs and inflammatory factors, activation of inflammatory pathways, and destruction of the BTB may be involved in the pathogenesis of VMI it is necessary to further explore how patient outcomes can be improved through immunotherapy.
Topics: Animals; Cellular Microenvironment; Fertility; Humans; Immunotherapy; Infertility, Male; Inflammation Mediators; Male; Orchitis; Signal Transduction; Testis; Varicocele
PubMed: 34531872
DOI: 10.3389/fimmu.2021.729539 -
The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review.Frontiers in Endocrinology 2022Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male... (Review)
Review
Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.
Topics: Male; Humans; Spermatozoa; Semen; Infertility, Male; Varicocele; Acupuncture Therapy
PubMed: 36329891
DOI: 10.3389/fendo.2022.1009537 -
Asian Journal of Andrology 2016Varicocele recurrence is one of the most common complications associated with varicocele repair. A systematic review was performed to evaluate varicocele recurrence... (Review)
Review
Varicocele recurrence is one of the most common complications associated with varicocele repair. A systematic review was performed to evaluate varicocele recurrence rates, anatomic causes of recurrence, and methods of management of recurrent varicoceles. The PubMed database was evaluated using keywords "recurrent" and "varicocele" as well as MESH criteria "recurrent" and "varicocele." Articles were not included that were not in English, represented single case reports, focused solely on subclinical varicocele, or focused solely on a pediatric population (age <18). Rates of recurrence vary with the technique of varicocele repair from 0% to 35%. Anatomy of recurrence can be defined by venography. Management of varicocele recurrence can be surgical or via embolization.
Topics: Adolescent; Adult; Age Factors; Child; Humans; Male; Phlebography; Recurrence; Risk Factors; Treatment Failure; Varicocele; Young Adult
PubMed: 26806078
DOI: 10.4103/1008-682X.171578 -
Asian Journal of Andrology 2016This Special Issue of is fully dedicated to the thematic area of Varicocele, which has been one of the most controversial issues in the field of Urology, Andrology, and...
This Special Issue of is fully dedicated to the thematic area of Varicocele, which has been one of the most controversial issues in the field of Urology, Andrology, and Reproductive Medicine. Recognized as a clinical entity for over a century, varicocele from Latin: (dilated vein) and from Greek: (tumor) still elicits heated debate among scientists and clinicians on an arguable negative effect on male fertility and gonadal function and has fueled thousands of scholarly articles since its first report in the 18 century.
Topics: Humans; Infertility, Male; Male; Varicocele
PubMed: 26780875
DOI: 10.4103/1008-682X.172819 -
Asian Journal of Andrology 2015Testicular varicocele, a dilation of the veins of the pampiniform plexus thought to increase testicular temperature via venous congestion, is commonly associated with... (Review)
Review
Testicular varicocele, a dilation of the veins of the pampiniform plexus thought to increase testicular temperature via venous congestion, is commonly associated with male infertility. Significant study has clarified the negative impact of varicocele on semen parameters and more recent work has shed light on its detrimental effects on the molecular and ultrastructural features of sperm and the testicular microenvironment, as well as more clearly defined the positive impacts of treatment on couples' fertility. The relationship between varicocele and testicular endocrine function, while known for some time based on histologic evaluation, has become more apparent in the clinical setting with a growing link between varicocele and hypogonadism. Finally, in the pediatric setting, while future study will clarify the impact of varicocele on fertility and testicular function, recent work supports a parallel effect of varicocele in adolescents and adults, suggesting a re-evaluation of current treatment approaches in light of the progressive nature of the condition and potential increased risk of future disease.
Topics: Adolescent; Adult; Fertility; Humans; Infertility, Male; Male; Reproductive Techniques, Assisted; Spermatozoa; Testis; Varicocele
PubMed: 25926610
DOI: 10.4103/1008-682X.153539 -
Asian Journal of Andrology 2016Varicocele is a common problem in reproductive medicine practice. A varicocele is identified in 15% of healthy men and up to 35% of men with primary infertility. The... (Review)
Review
Varicocele is a common problem in reproductive medicine practice. A varicocele is identified in 15% of healthy men and up to 35% of men with primary infertility. The exact pathophysiology of varicoceles is not very well understood, especially regarding its effect on male infertility. We have conducted a systematic review of studies evaluating the epidemiology of varicocele in the general population and in men presenting with infertility. In this article, we have identified some of the factors that can influence the epidemiological aspects of varicoceles. We also recognize that varicocele epidemiology remains incompletely understood, and there is a need for well-designed, large-scale studies to fully define the epidemiological aspects of this condition.
Topics: Humans; Infertility, Male; Male; Varicocele
PubMed: 26763551
DOI: 10.4103/1008-682X.172640 -
BMJ Clinical Evidence Jul 2015Varicocele is estimated to affect about 15% of the general male population. It usually occurs only on the left side, and is often asymptomatic. There is little evidence... (Review)
Review
INTRODUCTION
Varicocele is estimated to affect about 15% of the general male population. 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 overview, aiming to answer the following clinical question: What are the effects of treatments in adult males with varicocele? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
RESULTS
Searching of electronic databases retrieved 203 studies. After deduplication and removal of conference abstracts, 91 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 53 studies and the further review of 38 full publications. Of the 38 full articles evaluated, one existing systematic review was updated and two systematic reviews and five RCTs were added at this update. We performed a GRADE evaluation of nine PICO combinations.
CONCLUSIONS
In this systematic overview we categorised the efficacy for four interventions, based on information relating to the effectiveness of embolisation, expectant management, sclerotherapy, and surgical ligation.
Topics: Humans; Male; Sclerotherapy; Varicocele
PubMed: 26168774
DOI: No ID Found -
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 -
Journal of Assisted Reproduction and... Jul 2017Varicocele is found in approximately 20% of adults and adolescents and in 19-41% of men seeking treatment for infertility. It is associated with a decrease in sperm... (Review)
Review
Varicocele is found in approximately 20% of adults and adolescents and in 19-41% of men seeking treatment for infertility. It is associated with a decrease in sperm count as well as sperm motility and morphology. The currently accepted description of the pathophysiology of varicocele does not explain all its clinical manifestations; therefore, other factors such as genetic and epigenetic changes, associated with the environment, might be involved in causing infertility and decrease in sperm quality. It has been reported that the varicocele-induced deterioration of testicular function is progressive and interferes with fertility; hence, early and efficient assessment of the genetic manifestations in patients would be important for developing future medical interventions. Chromosomal disorders, mutations, polymorphisms, changes in gene expression, and epigenetic changes have all been reported to be associated with varicocele. Several studies are underway to unravel the genetic basis of this disease, as it is important to understand the origin and the aggravating factors to ensure appropriate guidance and intervention. Here, we review the available literature regarding the genetic and epigenetic changes associated with varicocele, and how these alterations are related to the different clinical manifestations of the disease.
Topics: DNA Fragmentation; DNA, Mitochondrial; Epigenesis, Genetic; Humans; Infertility, Male; Male; Oxidative Stress; Semen Analysis; Varicocele
PubMed: 28523408
DOI: 10.1007/s10815-017-0931-5