- Congenital absence of vas deferens and ectopic kidney. [Journal Article]
- IJInt J Surg Case Rep 2017; 34:90-92
- CONCLUSIONS: Congenital unilateral absence of the vas deference is a very rare clinical entity in the male population it has an incidence of 0.5-1.0%. it is usually discovered during evaluation for infertility or surgical procedures of the urogenital zone. Unilateral congenital absence of the vas deference is more associated with renal agenesis (73.3%), compared to the bilateral form (11.8%). CAVD is responsible of 1-2% of male infertility.Congenital absence of the vas deference is a unique clinical entity due to its great association with a large variety of urogenital abnormalities, we present this case to stress the importance of including scrotal examination in the routine physical exam to reduce the late diagnosis of such abnormality and it associated comorbidities.
- Serum levels of inhibin B in adolescents after varicocelelectomy: A long term follow up. [Journal Article]
- OMOpen Med (Wars) 2016; 11(1):204-206
- CONCLUSIONS: Inhibin B levels are a valid marker for studying the effects of varicocele on the testicular function and confirm the necessity of early surgical correction for preventing the trophic testicular damage and male infertility.
- The comparison of laparoscopic and microsurgical varicocoelectomy in infertile men with varicocoele on paternity rate 12 months after surgery: a prospective randomized controlled trial. [Journal Article]
- AAndrology 2017; 5(3):445-450
- The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is...
The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors' institution and designed as per protocol study. From 2012 till 2015 84 patients were randomly allocated to two groups. First group consisted of 42 patients who underwent laparoscopic varicocoelectomy, whereas patients from the second group underwent microsurgical varicocoelectomy. The indications for varicocoelectomy consisted of infertility >1 year, palpable left-sided varicocoele and at least one impaired semen parameter (sperm concentration <15 mln/mL; total motility<40%; progressive motility <32%, vitality <58% or normal morphology <4%). The primary goal was to show superiority of microsurgical varicocoelectomy over laparoscopic varicocoelectomy in terms of pregnancy rate. The secondary endpoints comprised assessment of sperm parameters in three-month intervals after intervention until one year. Other points included, LH, FSH and testosterone levels as well as testicle volume and International Index of Erectile Function. From each group five patients were lost during the follow-up period. The primary endpoint was not achieved - pregnancy rate in first and second group was 29.7% and 40.5% respectively (p = 0.34). Analysis of the sperm parameters after surgery revealed significant statistical difference in total motility, progressive motility and morphology in favour of microsurgical approach. Both methods showed improvement in all sperm parameters. There were no differences in hormonal levels as well as in erectile function and testicle volume between groups. Small number of patients in both groups are the main limitation of our study.
- Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. [Journal Article]
- HRHum Reprod Update 2017 Mar 10; :1-19
- Infertility is a global public health issue, affecting 15% of all couples of reproductive age. Male factors, including decreased semen quality, are responsible for ~25% of these cases. The dietary pa...
Infertility is a global public health issue, affecting 15% of all couples of reproductive age. Male factors, including decreased semen quality, are responsible for ~25% of these cases. The dietary pattern, the components of the diet and nutrients have been studied as possible determinants of sperm function and/or fertility.
- Magnesium Sulfate Mediate Morphine Administration Reduction in Varicocelectomy Surgery. [Journal Article]
- JIJ Invest Surg 2017 Mar 23; :1-5
- CONCLUSIONS: The experimental group with magnesium sulfate in its drug formulation showed better pain control compared to the control group which received only normal saline, whose pain manifested after every few hours. This can be used for the formulation of opium for this surgery in a large scale.
- The Dilemma of Adolescent Varicoceles: Do They Really Have to Be Repaired? [Review]
- CUCurr Urol Rep 2017; 18(5):38
- The primary indication for varicocele repair in adults, that of failed paternity, must be substituted in the adolescent population with surrogate parameters of testicular size differential and semen ...
The primary indication for varicocele repair in adults, that of failed paternity, must be substituted in the adolescent population with surrogate parameters of testicular size differential and semen analysis. Making recommendations based on these two parameters is incredibly difficult because studies often have contradictory findings, different patient populations, and lack of long-term follow up of the key endpoint, paternity. Therefore, it is not a surprise that recommendations for adolescent varicocele repair are general (with some exceptions) and necessarily so because of limitations in quality of evidence. Apart from pain, all indications for varicocele repair in adolescence remain controversial. This highlights the most important task for future studies: to prevent pediatric urologists from allowing a potentially damaging process to go untreated, while at the same time avoiding unnecessary intervention on a highly prevalent condition.
- Efficacy and safety of varicocelectomies: A meta-analysis. [Journal Article]
- SBSyst Biol Reprod Med 2017; 63(2):120-129
- This study reviewed the efficacy and safety of the three surgical approaches for varicocele (microsurgical, laparoscopic, and open varicocelectomy). A systematic review of the relevant randomized cli...
This study reviewed the efficacy and safety of the three surgical approaches for varicocele (microsurgical, laparoscopic, and open varicocelectomy). A systematic review of the relevant randomized clinical trials was performed. Trials were identified from specialized trials register of the Cochrane UGDP Group, the Cochrane library, additional electronic searches (mainly MEDLINE, EMBSAE, SCI, CBM), and handsearching. Clinical trials comparing microsurgical, laparoscopic and open varicocelectomies were included. Statistical analysis was managed using Review Manager 5.3. Seven clinical trials of 1,781 patients were included. The meta-analysis indicated that compared with open varicocelectomy, microsurgery had a higher pregnancy rate (p=0.002), while there was nonsignificant difference between microsurgical and laparoscopic varicocelectomies or between laparoscopic and open varicocelectomies. Both microsurgical and laparoscopic varicocelectomies had a greater increase in postoperative sperm concentration than open varicocelectomy (p=0.008 and p=0.001, respectively). Microsurgical varicocelectomy also showed better improvement in postoperative sperm motility (p=0.02). Compared with the other two, microsurgical varicocelectomy had the longest operative time (p=0.01 and p=0.0004 respectively). A nonsignificant difference was found in the hospital stay between the three approaches, whereas microsurgical and laparoscopic varicocelectomies had a shorter time to return to work. Moreover, microsurgical varicocelectomy had a lower incidence of postoperative complications and recurrence compared with the others. Analysis of current evidence shows that microsurgical varicocelectomy has a longer operative time, lower incidence of postoperative complications, and recurrence than laparoscopic and open varicocelectomies, and shows a higher pregnancy rate, with a greater increase in postoperative sperm concentration, better improvement in postoperative sperm motility, and shorter time to return to work than open varicocelectomy.
- Increased Level of c-kit in Semen of Infertile Patients with Varicocele. [Journal Article]
- UJUrol J 2017 Mar 16; 14(2):3023-3027
- CONCLUSIONS: Neither the sexual hormones nor the Sertoli cells was responsible for the infertility induced by varicocele.The aberrant expression of c-kit in infertile patients with varicocele may provide new insight into the mechanism of varicocele-associated infertility.
- Predictors for spontaneous pregnancy after microsurgical subinguinal varicocelectomy: a prospective cohort study. [Journal Article]
- IUInt Urol Nephrol 2017 Mar 15
- CONCLUSIONS: Our study indicated that males who underwent MVL with higher TMC and lower FSH preoperatively have higher possibility of pregnancy postoperatively.
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- Potential role of imaging in assessing harmful effects on spermatogenesis in adult testes with varicocele. [Review]
- WJWorld J Radiol 2017 Feb 28; 9(2):34-45
- Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalen...
Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging (MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.