Diagnosis of subclinical varicocele in infertility

Gonda, Roger L.; Karo, James J.; Forte, Renato; O'Donnell, Keith

doi:10.2214/ajr.148.1.71

Cited by 80 publications

(51 citation statements)

References 19 publications

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“…specificity of 94% (95% CI 0.79-0.99), providing our criterion of pathological reflux for the diagnosis of a varicocele was used as described in an earlier report (Dol et al, 1993). With an accuracy of 95% we accomplished better results than previous studies (Gonda et al, 1987;Fobbe etal, 1989;Petros etal, 1991;Eskew etal, 1993).…”

Section: Resultscontrasting

confidence: 39%

“…Another larger study concluded that contact thermography had a sensitivity of only 20% and the use was limited to quantification of a clinical varicocele (Basile-Fasole et al, 1986). Reports on colour Doppler scrotal ultrasound describe varying results; some found a high sensitivity and specificity up to 95% (Gonda et aL, 1987;Fobbe et al, 1989), one reported a high sensitivity of 93% but a specificity of only 33% (Petros et al, 1991) and in one study both sensitivity and specificity were low (Eskew et al, 1993). This may in part be explained by varying degrees of skilfulness of the examiners.…”

Section: Introductionmentioning

confidence: 99%

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The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele

et al. 1996

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Three non-invasive methods for the detection of a varicocele were evaluated in 63 men presenting with infertility. Physical examination, varicoscreen contact thermography and colour Doppler ultrasound were compared with spermatic venography as reference strategy. Physical examination had a sensitivity of 71%. Whether the non-palpable varicoceles are all subclinical is questionable since the specificity of physical examination was 69%. Varicoscreen proved to be quick, easy and cheap but of no clinical value (sensitivity 97%, specificity 9%). Colour Doppler ultrasound using strict criteria was a good diagnostic tool (sensitivity 97%, specificity 94%). No imaging difference was seen with colour Doppler ultrasound among clinical and subclinical varicoceles. Since the debate on treating all degrees of varicoceles is ongoing, we suggest that Doppler sonography should be a routine examination in infertile men.

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Section: Resultscontrasting

confidence: 39%

Section: Introductionmentioning

confidence: 99%

The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele

et al. 1996

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“…7,11,24,25 Gonda et al 7 reported that sonography had a 95% sensitivity for the detection of a varicocele, using a 2-mm cutoff for vein diameter, whereas other investigators recommended using 2.7 or 3 mm as the cutoff values. 20,26 However, vein enlargement alone is insufficient for the diagnosis of varicocele by sonography.…”

Section: Discussionmentioning

confidence: 99%

Incidence and importance of reflux in testicular veins of healthy men evaluated with color duplex sonography

Kocakoç

Kiris

Orhan

et al. 2002

J of Clinical Ultrasound

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Normal-sized testicular veins in healthy subjects had a remarkably high incidence of reflux induced by Valsalva's maneuver. The presence of reflux in subfertile men with normal testicular vein diameters is a diagnostic criterion, but it is necessary to quantify the reflux to prevent misdiagnosis of a varicocele and unnecessary surgery. The measurement of the duration and velocity limits of reflux in a large series of subjects may provide a reliable indicator for the diagnosis of varicocele.

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“…Clinical or subclinical varicocele 52 has been shown to cause male infertility in about 15% of infertile couples. 53 These patients have increased ROS in serum, testes, and semen samples.…”

Section: Varicocele and Osmentioning

confidence: 99%

REVIEW ARTICLE: Clinical Relevance of Oxidative Stress in Male Factor Infertility: An Update

Agarwal

Makker

Sharma

2007

American J Rep Immunol

678

507

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Male factor has been considered a major contributory factor to infertility. Along with the conventional causes for male infertility such as varicocele, cryptorchidism, infections, obstructive lesions, cystic fibrosis, trauma, and tumors, a new, yet important cause has been identified: oxidative stress. Oxidative stress (OS) is a result of the imbalance between reactive oxygen species (ROS) and antioxidants in the body, which can lead to sperm damage, deformity and eventually male infertility. This involves peroxidative damage to sperm membrane and DNA fragmentation at both nuclear and mitochondrial levels. OS has been implicated as the major etiological factor leading to sperm DNA damage. OS‐induced DNA damage can lead to abnormalities in the offspring including childhood cancer and achondroplasia. In this article, we discuss the need of ROS in normal sperm physiology, the mechanism of production of ROS and its pathophysiology in relation to male reproductive system. The benefits of incorporating antioxidants in clinical and experimental settings have been enumerated. We also highlight the emerging concept of utilizing OS as a method of contraception and the potential problems associated with it.

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Diagnosis of subclinical varicocele in infertility

Cited by 80 publications

References 19 publications

The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele

The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele

Incidence and importance of reflux in testicular veins of healthy men evaluated with color duplex sonography

REVIEW ARTICLE: Clinical Relevance of Oxidative Stress in Male Factor Infertility: An Update

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