Bilateral but not Unilateral Testicular Hypotrophy Predicts for Severe Impairment of Semen Quality in Men with Varicocele Undergoing Infertility Evaluation

Wu, Alex K.; Walsh, Thomas J.; Phonsombat, Surat; Croughan, Mary S.; Turek, Paul J.

doi:10.1016/j.urology.2007.12.074

Cited by 22 publications

(12 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…TMC was dichotomized into “poor” if less than 20 million and “normal” if greater than or equal to 20 million, as this cutoff has been previously accepted as a measure of sperm quality in multiple studies [8,9,14,19,20]. …”

Section: Methodsmentioning

confidence: 99%

The natural history of semen parameters in untreated asymptomatic adolescent varicocele patients: A retrospective cohort study

Chu

Zderic

Shukla

et al. 2017

Journal of Pediatric Urology

View full text Add to dashboard Cite

Summary Introduction Adolescent males with varicoceles present a dilemma for surveillance and treatment. Testicular volumetrics have not been shown to predict SA outcomes. Serial SAs are thus recommended in asymptomatic adolescent males with varicoceles and normal testicular development, but the natural history of semen parameters is unknown. Objective To explore the natural history of semen parameters in adolescent boys with a left varicocele under active surveillance. Study design Adolescents with an asymptomatic unilateral left varicocele, Tanner V development, normal testicular volumes, and an initial SA were retrospectively reviewed in a single-institution prospectively followed cohort. Total motile count (TMC) was calculated. A cutoff of TMC Z 20 million was used to dichotomize SA results into “normal” or “poor.” Those with poor SA were offered repeat SA. Cumulative probabilities of normal TMC over successive rounds of SA were calculated. Bivariate models were used to explore associations of a second consecutive poor TMC with age and varicocele grade. Results A total of 216 patients provided an initial SA between 1992 and 2015. We excluded 17 for a history of cryptorchidism or incomplete SA data for a final cohort of 199 patients with median follow-up of 3.3 years (interquartile range 1.5–5.6 years). The mean age at initial SA was 17.9 years (range 14.8–21.8 years). One hundred and nine out of 199 had an initial normal TMC. Of the 90 out of 199 with an initially poor TMC, 51 had repeat SA and 24 of the 51 patients improved to normal TMC. Of the 27 patients with two consecutive poor TMCs, 15 had a third SA and five out of 15 improved to normal TMC. Thus, cumulatively, 55%, 67%, and 69% of all patients had a normal TMC after an initial, second, and third SA, respectively. However, fewer patients in each round of SA normalized their TMC (Figure). Neither age nor varicocele grade was associated with a second consecutive poor TMC. Discussion Two-thirds of Tanner V boys with an uncorrected varicocele and normal testicular volumes achieve a normal TMC regardless of varicocele grade or age. Despite Tanner V development, 47% with an initial “poor” SA will improve to normal status without surgery. However, a small subgroup of patients will have persistently poor TMC and thus should be targeted in future research for timely intervention. Conclusion Semen parameters improve over time. SA should be followed and repeated at least once in symptomatic Tanner V boys with varicoceles.

show abstract

Section: Methodsmentioning

confidence: 99%

The natural history of semen parameters in untreated asymptomatic adolescent varicocele patients: A retrospective cohort study

Chu

Zderic

Shukla

et al. 2017

Journal of Pediatric Urology

View full text Add to dashboard Cite

show abstract

“…Artery sparing technique is advised in patients who have previously undergone varicocelectomy, inguinal hernia, solitary testis and testicular atrophy (Zampieri et al ., ; Wu et al ., ). Matsuda et al .…”

Section: Discussionmentioning

confidence: 97%

Different surgical techniques and L-carnitine supplementation in an experimental varicocele model

et al. 2013

View full text Add to dashboard Cite

We aimed to investigate the impact of various varicocelectomy techniques and/or L-carnitine as an adjunct treatment, following the emergence of oxidative stress, on the expression levels of SCF/c-kit signalling pathways in spermatogenesis. Forty-two rats were divided into seven groups: group 1 (G1) control; group 2 (G2) sham; group 3 (G3) varicocele; group 4 (G4) varicocele + varicocelectomy with testicular nonartery sparing; group 5 (G5) same as G4 but with artery sparing; group 6 (G6) same as G4 but with L-carnitine and group 7 (G7) same as G5 with L-carnitine. mRNA expression levels of SCF and c-kit were measured quantitatively using real-time polymerase chain reaction. CASP-3 activity at protein level was determined, and histological evaluation was performed. mRNA expression level of SCF increased in G6 as compared to control group (3.52-folds change; P = 0.035), whereas mRNA expression level of c-kit gene remained the same. We found that in the left testis of G6 group, mRNA expression level of SCF increased 2.2-folds in comparison with the right testis (P < 0.05). There were no statistically significant differences in the CASP-3 protein expression levels between the control and other groups. When Cosentino Score analyses of immunostaining were conducted, we observed no significant differences among groups. Spermatogenic failure could be primarily due to a sertoli cell dysfunction. Although surgical treatment has been the best option for management of varicocele, auxiliary agents like L-carnitine may be considered as supportive treatment regimes in addition to conventional surgical treatments.

show abstract

“…There is strong evidence that varicocele surgery restores testicular volumes and semen parameters [67] . In a recent meta-analysis by Marmar et al [68] , varicocele surgery was associated with improvement in the rates of spontaneous pregnancies in couples with…”

Section: Treatmentmentioning

confidence: 99%

Testicular Varicocele: An Overview

Mohammed

Chinegwundoh²

2009

Urol Int

View full text Add to dashboard Cite

Testicular varicocele or varicocele is one of the common causes of scrotal swelling. It is predominantly found in the adolescent and young adult age group and it can adversely affect testicular function in a variety of ways. There is a considerable debate about the effects of varicoceles on future fertility, but the current evidence suggests that varicoceles are found in a higher percentage among males attending the infertility clinics and that treatment of varicoceles is associated with increased spontaneous conception rates among infertile couples. In this article we give an overall view on the aetiology, adverse effects and management of varicoceles.

show abstract

Bilateral but not Unilateral Testicular Hypotrophy Predicts for Severe Impairment of Semen Quality in Men with Varicocele Undergoing Infertility Evaluation

Cited by 22 publications

References 28 publications

The natural history of semen parameters in untreated asymptomatic adolescent varicocele patients: A retrospective cohort study

The natural history of semen parameters in untreated asymptomatic adolescent varicocele patients: A retrospective cohort study

Different surgical techniques and L-carnitine supplementation in an experimental varicocele model

Testicular Varicocele: An Overview

Contact Info

Product

Resources

About