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Alejandra Parrilli, Agnese Roberti, Maria Escolino, Ciro Esposito
BACKGROUND: Varicocele represents one of the most common surgically correctible urologic anomalies in adolescent males. The best procedure for the treatment of adolescent varicocele has not been established, but with recent advances in minimal access surgery, there have been many reports praising the safety and efficacy of laparoscopy and retroperitoneoscopy for the surgical correction of varicocele in adolescent. The aim of this review is to compare the results of Palomo's technique, with retroperitoneoscopic and transperitoneoscopic approaches in adolescent, analyzing recurrence, testicular growth and complications...
October 2016: Translational pediatrics
M Binhazzaa, E Bounasr, G Perez, T Almont, M Soulie, M Faruch, E Huyghe
INTRODUCTION: Subinguinal microscopic ligation is the current standard of treatment of varicocele, and percutaneous embolization is a new alternative. We aimed to compare these procedures for reproductive and functional aspects. MATERIAL: A consecutive series of 76 patients with clinical varicocele, alteration of semen parameters and infertility, undergoing either procedure (microsurgery in 49 cases and embolization in 27 cases) was prospectively analyzed preoperatively and postoperatively (at 1, 3, 6, 9 and 12 months)...
December 2016: Progrès en Urologie
David I Chu, Stephen A Zderic, Aseem R Shukla, Arun K Srinivasan, Gregory E Tasian, Dana A Weiss, Christopher J Long, Douglas A Canning, Thomas F Kolon
PURPOSE: The main indications for adolescent varicocelectomy are testicular hypotrophy or pain. However, we have previously shown that both serial total testicular volume and volume differential are weakly associated with semen quality. The ultimate patient goal is paternity, but semen analysis is critical to appropriate management of varicocele. We hypothesize that varicocelectomy improves total motile count (TMC) among patients who only have abnormal semen analysis (SA) parameters, but not among those with potential hormonal dysfunction such as Klinefelter syndrome or cryptorchidism...
October 26, 2016: Journal of Pediatric Urology
Y G Chen, S F Chen, Y J Yang, A A Long, X Q Liu
Objective: To investigate the expression of microRNA 210 (miR-210) in the epididymis of rats with varicocele and changes in miR-210 expression following high spermatic vein ligation, so as to explore the significance of the surgery in treating varicocele. Methods: A total of 21 male Sprague-Dawley (SD) rats aged 7 weeks were randomly divided into control group (n=7), experimental group (n=7), and surgical group (n=7). Varicocele model was established in both the experimental and surgical groups, while only vein isolation was performed in the control group...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yasuhiro Shibata, Sota Kurihara, Seiji Arai, Haruo Kato, Tomomi Suzuki, Yoshiyuki Miyazawa, Hidekazu Koike, Kazuto Ito, Tetsuya Nakamura, Kazuhiro Suzuki
OBJECTIVES: Microsurgical subinguinal varicocelectomy is one of the best treatment modalities for varicoceles related to male infertility and scrotal pain. However, the difficulty in identifying testicular arteries, which should be spared, is a limitation of this technique. To visualize and identify the testicular arteries in spermatic cord during the operation, we examined the efficacy of intraoperative indocyanine green angiography (ICGA), which is regularly used in microsurgical neurosurgery...
October 13, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Tae Ho Lee, Jay Ho Jung, Young Kwon Hong
The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%)...
September 2016: Chonnam Medical Journal
Mingchao Li, Zhengyun Wang, Hao Li
OBJECTIVE: To perform a meta-analysis of data from available published studies comparing laparoendoscopic single-site surgery varicocelectomy (LESSV) with conventional transperitoneal laparoscopic varicocele ligation. METHODS: A comprehensive data search was performed in PubMed and Embase to identify randomized controlled trials and comparative studies that compared the two surgical approaches for the treatment of varicoceles. RESULTS: Six studies were included in the meta-analysis...
September 29, 2016: Journal of International Medical Research
Li-Qiang Guo, Xiu-Lin Zhang, Yu-Qiang Liu, Wen-Dong Sun, Sheng-Tian Zhao, Ming-Zhen Yuan
The aim of this study is to evaluate the benefits of laparoscopic Doppler ultrasound (LDU) application during laparoscopic varicocelectomy (LV), and to compare the surgical outcomes and complications between LDU-assisted LV (LDU-LV) and conventional LV for infertile patients with varicoceles; 147 infertile patients were randomly divided into two groups. Operative and postoperative parameters, semen parameters, and the pregnancy rate were compared. There were no differences in baseline demographics. The operative time was significantly longer in LDU-LV group than LV group...
September 27, 2016: Asian Journal of Andrology
Tao Wu, Xi Duan, Xuesong Yang, Xianzhong Deng, Shu Cui
PURPOSE: To present a systematic review and meta-analysis comparing laparoendoscopics single-site varicocelectomy (LESS-V) versus conventional laparoscopic surgery (CTL-V). METHODS: A literature search was performed using The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded and Google Scholar. Literature reviewed included meta-analyses, and randomized and nonrandomized prospective studies. We utilized weight mean difference (WMD) to measure hospital stay, time to return normal activity, postoperative pain and improvement of semen parameters and odds ratio (OR) to postoperative complications and cosmetic satisfaction...
2016: SpringerPlus
Hossein Karami, Amin Hassanzade Hadad, Morteza Fallahkarkan
PURPOSE: To evaluate postoperative results of laparoscopic varicocelectomy using bipolar electrosurgery and analyze semen according to the grade of varicocele after surgery. MATERIALS AND METHODS: In a six-year period, 416 men with clinical varicocele and impaired semen parameters or infertility underwent laparoscopic varicocelectomy using bipolar electrosurgery. All patients were assessed for hydrocele and recurrence of varicocele six months and one year after the procedure...
August 25, 2016: Urology Journal
Koji Chiba, Masato Fujisawa
Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears to have beneficial effects in men with impaired semen parameters and palpable varicoceles...
August 2016: World Journal of Men's Health
N Alhathal, M San Gabriel, A Zini
There is evidence to show that varicocele repair can improve conventional sperm parameters but the effects on sperm chromatin integrity have not been fully elucidated. We sought to examine the effects of varicocelectomy on sperm maturation, nuclear chromatin integrity and nuclear sulfhydryl groups. We conducted a prospective study of consecutive infertile men (n=29) that underwent a microsurgical sub-inguinal varicocelectomy for treatment of a clinically palpable varicocele and abnormal semen parameters. Six healthy sperm donors served as controls...
August 27, 2016: Andrology
Koji Shiraishi, Shintaro Oka, Hideyasu Matsuyama
INTRODUCTION AND OBJECTIVE: The ability of testicular histopathology to predict the success of a microsurgical varicocelectomy (VR) in patients with non-obstructive azoospermia (NOA) was investigated. We used a next-generation sequencer to compare the transcriptomes of VR-responsive and non-responsive testes to identify the factors that predict sperm in the ejaculate. METHODS: Eighty-three men with NOA and a left varicocele underwent microsurgical VR with simultaneous testicular biopsy...
August 18, 2016: Journal of Urology
Jung Keun Lee, Ho Young Ryu, Jae-Seung Paick, Soo Woong Kim
BACKGROUND: Microsurgical subinguinal varicocelectomy (MSV) is considered an effective and less morbid procedure, but the difficulty in preserving testicular arteries is a limitation of this procedure. We identified the microanatomy encountered during MSV and clarify its significance to the difficulty of the procedure. METHODS: Three hundred and twenty-six patients who underwent left MSV were evaluated. Detailed intraoperative microanatomy was recorded for each case...
2016: SpringerPlus
Khaleeq Ur Rehman, Hafsa Zaneb, Ahsan Numan, Abdul Basit Qureshi, Imtiaz Rabbani, Mohamad Shehbaz Yousaf, Habib Ur Rehman
OBJECTIVE: To investigate venous blood gases (VBG) in varicocele veins and correlation with semen and testicular blood flow. MATERIAL AND METHODS: Twenty-seven infertile patients, undergoing left microsurgical varicocelectomy, at Urology/Andrology Department of a teaching hospital, were included. Before surgery semen parameters were recorded and scrotal color doppler ultrasonography (CDUS) done to measure peak systolic velocity (PSV) resistive index (RI) of sub capsular and intra parenchymal branches of testicular artery...
July 13, 2016: Urology
Turgay Ebiloglu, Yasin Aydogmus, Engin Kaya, Ender Oral, Omer Kaplan, Yusuf Kibar
INTRODUCTION: To evaluate the effect of physical activity on varicocele pain and how different varicocelectomy techniques relieve this pain. MATERIALS AND METHODS: Between November 2012 and January 2015, a total of 64 patients with left groin pain and clinical varicocele were enrolled in this study. A visual analogue scale (VAS) classifying the pain in ten scores was used to assess the severity of pain before and after beginning continuous physical activity, and after operations...
June 2016: Canadian Journal of Urology
M Raghavendran, A Venugopal, V Ranjit, Vinay N Kaushik
A 30-year old infertile male was admitted for microsurgical sub inguinal varicocelectomy. Intraoperatively, two tubular structures of the caliber of neighboring veins were noted. They were distinct from the vas, which was carefully preserved. Histopathology revealed varicose veins along with two convoluted tubular structures lined by ciliated pseudo-stratified epithelium. There was an incomplete thin muscle coat. The lumina were irregular and contained no spermatozoa (Fig. 1). These structures were identified as paradidymis based on the location in the cord and microscopic morphology...
July 2016: Urology Case Reports
Dilek Ömür, Hüseyin Oğuzalp, Hasan A Kiraz, Serpil Ekin, Cabir Alan, Ahmet R Ersay, Volkan Hancı
OBJECTIVES: To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. METHODS: This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls)...
June 2016: Saudi Medical Journal
Nishant Patel, Michael Santomauro, Sarah Marietti, George Chiang
PURPOSE: To describe our experience utilizing Laparoendoscopic single site (LESS) surgery in pediatric urology. MATERIALS AND METHODS: Retrospective chart review was performed on LESS urologic procedures from November 2009 through March 2013. A total of 44 patients underwent 54 procedures including: nephrectomy (23), orchiopexy (14), varicocelectomy (9), orchiectomy (2), urachal cyst excision (3), and antegrade continence enema (3) (ACE). RESULTS: Median patient age was 6...
March 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
R M Mostafa, R Abol-Magd, S E Younis, O F Dessouki, M Azab, T Mostafa
This study aimed to assess seminal mast cells in infertile men associated with varicocele (Vx) pre- and post-surgical repair. Forty-five infertile men associated with Vx were subjected to history taking and clinical examination. In addition, semen parameters and seminal mast cells stained with 1% toluidine blue were estimated pre-varicocelectomy and three months post-varicocelectomy. Vx surgical repair revealed a significant improvement in the mean sperm concentration, progressive sperm motility, total sperm motility and sperm abnormal morphology and a significant decrement in seminal mast cells (mean ± SD, 3...
June 1, 2016: Andrologia
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