Renal injury after surgical intervention is not uncommon in current urological practice with most complication would be anticipated in high risk patient. Subcapsular renal hematoma is not known complication post some urological interventions such as extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and trauma. Few cases of subcapsular hematomas are reported as a complication post ureteroscopy in the literature. Clinical spectrum varies from spontaneous resolution through acute renal failure secondary to Page kidney. Page kidney is the external compression of a kidney usually caused by a subcapsular hematoma associated with high blood pressure and occasional renal failure. It is named after Dr. Irvin Page who first demonstrated in 1939 that applying external compression on the renal parenchyma could cause hypertension. Various management options are mentioned in literature and depend upon the severity and presentation. Percutaneous drainage is an option for the management of subcapsular hematoma in hemodynamically stable patient.
Purpose
The present study was conducted to analyze the effect of varicocelectomy on serum follicle-stimulating hormone (FSH) and testosterone. The interrelationship between seminal and hormonal variables is also investigated.
Patients and Methods
A prospective cohort study was conducted on patients of the urology clinic from 2012 to 2017. The study was conducted in the Security Forces Hospital, in Riyadh, Saudi Arabia. Infertile patients who had already undergone the FSH examination and testosterone twice were included in the study. Statistical Package for Social Sciences (SPSS) version 21.0 was used to analyze the data.
Results
A total of 186 patients were studied which reveals that the age group of 21–30 years was higher than other age groups 80 (43%), micro varicocelectomy was performed in 138 (74%) of patients and 79 (47%) patients had one-year infertility. The study assessed the effect of varicocelectomy on sperm count and motility serum FSH, testosterone, luteinizing hormone (LH), and prolactin, and it was found that none of the variables showed significant association after varicocelectomy, except for luteinizing hormone (P-value = 0.014). Testosterone levels in patients who had FSH ≤10 were also evaluated and it was found that the level of testosterone was increased with a decreased level of FSH (P-value = 0.005).
Conclusion
It was concluded from our results that after varicocelectomy, those patients who had FSH levels ≤10 were found to have increased testosterone levels. LH was also found to be significant; however, other hormones were not found to be significant. This may occur due to the reason that we have the majority of the participants in the age group 21–30. Further prospective studies are needed to evaluate the association with ample sample size.
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