Efficacy of Bilateral and Left Varicocelectomy in Infertile Men With Left Clinical and Right Subclinical Varicoceles: A Comparative Study

Zheng, Yi Qun; Gao, Xin; Li, Zhi Jian; Yu, Yuan Long; Zhang, Zhi Gang; Wei, Li

doi:10.1016/j.urology.2008.11.050

Cited by 73 publications

(49 citation statements)

References 29 publications

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“…Varicocele management, however, has always been a controversial issue because very few randomized, controlled studies have been performed to examine varicocelectomy as an infertility treatment. Significant evidence suggests that varicoceles have a harmful effect on the testis and that varicocelectomy can not only prevent progressive decline in testicular function but also reverse the damage [23][24][25] . However, the degree to which varicocele repair improves pregnancy rates and the success of assisted reproductive technology remains controversial.…”

Section: Scrotal Us Findings In Non Obstructive Azoospermiamentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a "detailed map" for guiding corrective operative interventions.

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Section: Scrotal Us Findings In Non Obstructive Azoospermiamentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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“…Zheng et al[21] completed a prospective study of 104 infertile men with left clinical and right subclinical varicoceles who underwent either bilateral varicocelectomy or left varicocelectomy alone. In attempt to determine whether it is necessary to perform bilateral varicocelectomy in men with left clinical and right subclinical varicoceles, the authors compared a number of preoperative and 12-month postoperative variables that included serum testosterone levels.…”

mentioning

confidence: 99%

The impact of varicocele and varicocele repair on serum testosterone

Tanrikut

McQuaid

Goldstein

2011

Current Opinion in Obstetrics &Amp; Gynecology

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Definitive statements regarding varicocele, varicocelectomy, and testosterone are difficult to make given the frequent absence of control groups and lack of sample group consistency. Despite this, recent well done animal and human studies suggest an adverse effect of varicocele on testosterone and a potential benefit of varicocele repair. Further controlled studies examining testosterone as a primary data point are required.

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“…However Zheng et al [12] found no significance between similar groups [51 of 104 with right associated varicoceles (49%)]. We prefer to perform bilateral varicocelectomy in cases of a confirmed sonographic diagnosis.…”

Section: Discussionmentioning

confidence: 84%

Comparison of Inguinal Approach, Scrotal Sclerotherapy and Subinguinal Antegrade Sclerotherapy in Varicocele Treatment: A Randomized Prospective Study

Fayez¹,

Shantaly

Abbas³

et al. 2010

Urol Int

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We compared outcome and complications of three simple varicocelectomy techniques. Groups were divided according to whether they would receive the Ivanissevich technique (n = 55), Tauber’s technique (n = 51) or subinguinal sclerotherapy (n = 49). Selection criteria were: infertility >1 year, subnormal semen, sonographic diameter of veins >3 mm and time of regurge >2 s. Patients were randomly assigned to the groups of treatment, with follow-up every 3 months for 1 year. Improvement was only in sperm count and total motility for all groups. Pregnancy rates were 20, 13.73 and 12.24%, respectively, with no significant difference between groups. Hydrocele occurred only in the group which received the Ivanissevich technique (5.5%). Tauber’s technique is simple; however, it has the disadvantage of multiple branching of small veins.

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Efficacy of Bilateral and Left Varicocelectomy in Infertile Men With Left Clinical and Right Subclinical Varicoceles: A Comparative Study

Cited by 73 publications

References 29 publications

Imaging in male-factor obstructive infertility

Imaging in male-factor obstructive infertility

The impact of varicocele and varicocele repair on serum testosterone

Comparison of Inguinal Approach, Scrotal Sclerotherapy and Subinguinal Antegrade Sclerotherapy in Varicocele Treatment: A Randomized Prospective Study

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