Strong correlations were found between real-time strain elastography and the testicular volume, varicocele grade, and sperm morphologic characteristics. Real-time strain elastography is a simple, noninvasive investigative modality that can potentially be used to study the structure and function of the testicular tissue in varicocele.

IntroductionHydrocele development is the most common complication after varicocele repair. The beginning of this kind of hydrocele is variable. The shortest reported onset is one week. In the present report we describe an unusual immediate onset of hydrocele formation following varicocele repair. This represents the first report of a harsh hydrocele onset in the literature.Case presentationA 29-year-old Caucasian male noticed the development of a big hydrocele just a few hours after inguinal varicocelectomy. The hydrocele remained stable in size throughout 12 years until a hydrocelectomy was done.ConclusionMass ligation and division of the spermatic cord structures during varicocele surgery should be avoided. Instead, lymphatic sparing is highly recommended. Differentiation between testicular edema and hydrocele should be confirmed as early as possible to assure the patient properly. This case study highlights the importance of our knowledge about the surgical anatomy of the spermatic cord structures. It definitely advances our understanding of a post-varicocelectomy hydrocele etiology and development. It is an original case report of interest to andrologists, urologists and general surgeons.

COVID-19 is a new global pandemic. It can affect multiple body systems and functions. However, the relationship between COVID-19 and male sexual activity did not yet get much consideration. Herein, we report the impact of COVID-19 on sexual function in 3 men who recovered from the disease. Compared with their condition before catching the infection, the men showed, in different degrees, a decline in all aspects of sexual function as assessed by the international index of erectile function. They started to develop premature ejaculation or exacerbate an already existing condition according to the premature ejaculation diagnostic tool scoring. Beck’s depression inventory revealed deterioration of the men’s moods up to severe depression. The sex-related hormones (testosterone-total and free, luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol) of these men were within normal levels. To the best of our knowledge, this is the first case report documenting deleterious changes in mood and several aspects of sexual functioning in males after recovery from the COVID-19 using validated measurement tools. Follow-up and psychological support of the recovered men may help mend their moods and consequently upgrade their sexual functioning.

Purpose: To report the different patterns of estradiol levels in infertile men with non-obstructive azoospermia and correlate these levels with their clinical and laboratory findings. Materials and methods: A retrospective study was launched, and a retrieval of data for infertile men with non-obstructive azoospermia ( n = 166) and fertile controls ( n = 40) was performed. The retrieved data included demographics, clinical findings, scrotal duplex, semen analysis, and hormonal assay (testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, and estradiol). Results: Our findings showed a wide spectrum of estradiol concentrations. The patients were arranged into three groups (high, normal, and low estradiol groups). The normal estradiol group was the most prevalent (71.1%). Testosterone, gonadotrophins, testicular volumes, and the number of patients with jobs in polluted workplaces showed significant differences among the study groups ( p = 0.001, <0.001, <0.001, and 0.004, respectively). Age, body mass index, varicocele prevalence, prolactin, and smoking habits did not show any significant differences among the groups. Obesity was lacking in the low estradiol group, but it had significantly higher prevalence in the normal ( p = 0.013) or high group ( p = 0.023) compared with the controls. Conclusion: Serum estradiol, in infertile men with non-obstructive azoospermia, may be present at different levels. It is recommended that estradiol be measured in infertile men with non-obstructive azoospermia when there is an alteration in testosterone concentration, obesity, a polluted workplace occupation, or before trying hormonal therapy. Extended studies are highly recommended to provide a clear clue whether alterations in estradiol concentrations in men with non-obstructive azoospermia are the cause or a consequence of the condition.

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