Effect of microsurgical varicocelectomy on fertility outcome and treatment plans of patients with severe oligozoospermia: An original report and meta‐analysis

Majzoub, Ahmad; Elbardisi, Haitham; Covarrubias, Simryn; Mak, Nicole; Agarwal, Ashok; Henkel, Ralf; ElSaid, Sami; Al-Malki, Ahmad H.; Arafa, Mohamed

doi:10.1111/and.14059

Cited by 17 publications

(19 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A varicocele represents an abnormal enlargement of the veins within the pampiniform plexus and has been recognized as one of the most frequent causes of infertility in men, with an incidence in the pediatric population of 10-15% [1]. Around 40% of adult males with this abnormality are infertile [1][2][3]. The usual modality of treatment, with a very high success rate, is surgical varicocelectomy.…”

Section: Introductionmentioning

confidence: 99%

“…The usual modality of treatment, with a very high success rate, is surgical varicocelectomy. Today, several surgical approaches for successful varicocele treatment are available, including open inguinal, subinguinal microscopic laparoscopic, and robotic-assisted laparoscopic ligation [1][2][3][4]. Due to the benefits of minimally invasive surgery, laparoscopic varicocelectomy has been popularized and has gained growing acceptance among pediatric surgeons [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

et al. 2021

View full text Add to dashboard Cite

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (p = 0.001) was found. Additionally, the interaction between time and different local analgesics (p < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (p < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine—n = 4, 20%; 0.5% levobupivacaine—n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (p < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The literature reveals similar pregnancy rates after varicocoelectomy, ranging from 26% to 60%. 10,11,13 spermatozoa as good prognosis). 33 We demonstrated that participants whose SA parameters improved after the procedure displayed different pre-operative seminal metabolome profile from those who did not improve.…”

Section: Discussionmentioning

confidence: 96%

“…In fact, literature shows SA improvement rates ranging from 64% to 81%, [10][11][12] and natural pregnancy rates from 29% to 60% after MV. 8,10,13 Furthermore, predicting varicocoelectomy outcomes at individual level is a difficult task. Despite the identification of several aspects that affect varicocoelectomy outcomes, such as age, varicocoele grade, body mass index (BMI) testicular size, sperm concentration, sperm motility, follicle-stimulating hormone (FSH) levels, and inflammation markers, 11,12,[14][15][16][17] to this date, there are no clinically validated predictors or prediction tools that precisely foresee MV outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prediction of semen analysis parameter improvement after varicocoelectomy using 1 H NMR‐based metabonomics assays

et al. 2022

View full text Add to dashboard Cite

Background Varicocoele is the most common correctable cause of male infertility; however, predicting varicocoelectomy outcomes is difficult. “Omics” techniques have been increasingly used to develop new diagnostic and prognostics tools for several male infertility causes, and could be applied to study varicocoele. Objectives The objective is to create metabolomics models capable of segregating men who improved semen analysis (SA) parameters or achieved natural pregnancy after microsurgical varicocoelectomy (MV) from those who did not, using hydrogen‐1 nuclear magnetic resonance (1H NMR) spectra of seminal plasma of pre‐operative samples. Material and methods We recruited 29 infertile men with palpable varicocoele. 1H NMR spectra of seminal plasma were obtained from pre‐operative samples and used to create metabonomics models. Improvement was defined as an increase in the total motile progressive sperm count (TMC) of the post‐operative SA when compared to the baseline, and pregnancy was assessed for 24 months after MV. Results Using linear discriminant analysis (LDA), we created a model that discriminated the men who improved SA from those who did not with accuracy of 93.1%. Another model segregated men who achieved natural pregnancy from men who did not. We identified seven metabolites that were important for group segregation: caprylate, isoleucine, N‐acetyltyrosine, carnitine, N‐acetylcarnitine, creatine, and threonine. Discussion We described the use of metabonomics model to predict with high accuracy the outcomes of MV in infertile men with varicocoele. The most important metabolites for group segregation are involved in energy metabolism and oxidative stress response, highlighting the pivotal role of these mechanisms in the pathophysiology of varicocoele. Conclusions 1H NMR spectroscopy of seminal plasma can be used in conjunction with multivariate statistical tools to create metabonomics models useful to segregate men with varicocoele based on the reproductive outcomes of MV. These models may help counseling infertile men with varicocoele regarding their prognosis after surgery.

show abstract

“…It has been demonstrated that varicocelectomy in men with abnormal semen parameters was associated with better fertility outcome. The adjuvant drug therapy, especially different types of antioxidants, seems to be associated with better fertility outcome, in comparison with no medical treatment ( 31 , 32 ). Therefore, assessment of some antioxidants such as LC could be beneficial for clinical purposes.…”

Section: Discussionmentioning

confidence: 99%

Seminal L-Carnitine In Infertile Oligoasthenoteratozoospermic Men with Varicocele

Mostafa¹,

Abougabal²,

Mintziori³

et al. 2022

JRI

View full text Add to dashboard Cite

Background: Few studies have investigated the relationship of seminal L-Carnitine (LC) with male infertility associated with varicocele. The purpose of this prospective cross-sectional study was to assess seminal plasma LC levels in infertile oligoathenoteratozoospermic (OAT) men with varicocele. Methods: Overall, 86 men were investigated. They were divided into infertile OAT men with varicocele (n=45), infertile OAT men without varicocele (n=21), and fertile men (n=20) as a control group. According to WHO guidelines, these men were subjected to history taking, clinical examination, and semen analysis. Seminal LC levels were evaluated by the colorimetric method. Statistical comparisons were done using Kruskal-Wallis and Mann-Whitney U tests and correlations were verified by the Pearson test. P-value<0.05 was set to be statistically significant. Results: The mean seminal plasma LC levels were significantly lower in infertile OAT men with varicocele (216.3±57.1 ng/ml) compared to infertile OAT men without varicocele (252.9±62.9 ng/ml, p=0.01), or fertile men (382.8±63.6 ng/ml, p= 0.001). Besides, the mean seminal plasma LC level exhibited statistically significant decreases in infertile OAT men of varicocele grade III compared to varicocele grade II cases, and in infertile OAT men with bilateral varicocele compared with unilateral varicocele cases. Collectively, there was a statistically significant positive correlation between seminal LC levels with sperm concentration, motility, and normal morphology. Conclusion: Seminal LC levels are expressively reduced in infertile OAT men with varicocele and are influenced by an increase in varicocele grade and laterality.

show abstract

Effect of microsurgical varicocelectomy on fertility outcome and treatment plans of patients with severe oligozoospermia: An original report and meta‐analysis

Cited by 17 publications

References 35 publications

The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

Prediction of semen analysis parameter improvement after varicocoelectomy using 1 H NMR‐based metabonomics assays

Seminal L-Carnitine In Infertile Oligoasthenoteratozoospermic Men with Varicocele

Contact Info

Product

Resources

About