Extended indications for varicocelectomy

Machen, G. Luke; Sandlow, Jay

doi:10.12688/f1000research.19579.1

Cited by 9 publications

(6 citation statements)

References 58 publications

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“…It is thought to be primarily related to small vessel obstruction and venous stasis in the scrotum, causing raised scrotal temperature and tissue hypoxia. This, in turn, causes germinal cell dysfunction and reduces spermatogenesis [4,6,7]. Other explanations for infertility in varicocele patients include endocrinological changes and the back flow of adrenal and renal metabolic products through the left internal spermatic vein [6,8].…”

Section: Introductionmentioning

confidence: 99%

“…This has been linked to sperm DNA damage, including DNA fragmentation, and correlated with the decreased capacity of spermatozoa to fertilise oocytes during normal fertilisation and assisted reproduction techniques (ARTs, in vitro fertilisation and intracytoplasmic sperm injection [ICSI]) [6,9]. Studies have also reported a higher prevalence of DNA fragmentation in varicocele patients and a correlation between the presence of varicocele and impaired sperm DNA integrity [7,10]. Furthermore, Zavattaro et al reported that around 15% of varicocele patients with normal semen analysis are diagnosed as infertile [5].…”

Section: Introductionmentioning

confidence: 99%

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The effects of varicocelectomy on the DNA fragmentation index and other sperm parameters: a meta-analysis

Birowo

Wijaya

Atmoko

et al. 2020

Basic Clin. Androl.

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Background Varicocele is one of the most common causes of reversible male infertility, and 15% of the varicocele patients with normal semen analysis are diagnosed as infertile. According to the current guidelines, varicocelectomy is indicated based on abnormal sperm parameters and not abnormal DNA fragmentation index (DFI) values. Thus, in this study, we performed a meta-analysis of the effects of varicocelectomy on the DFI and other conventional sperm parameters, and determined whether DFI could be used to indicate varicocelectomy for varicocele patients. Results Through an electronic search of the PubMed, Scopus, EBSCO, and Cochrane databases, we included 7 prospective studies including a total of 289 patients in this meta-analysis. The results showed that varicocelectomy significantly reduced DNA fragmentation (mean difference: − 6.86; 95% confidence interval [CI]: − 10.04, − 3.69; p < 0.00001) and improved sperm concentration (mean difference: 9.59; 95% CI: 7.80, 11.38; p < 0.00001), progressive motility (mean difference: 8.66; 95% CI: 6.96, 10.36; p < 0.00001), and morphology (mean difference: 2.73; 95% CI: 0,65, 4.80; p = 0.01). Conclusion Varicocelectomy reduced DNA fragmentation and improved sperm concentration, progressive motility, and morphology. Additionally, the analysis showed that an abnormal DFI measurement should be considered as an indication for varicocelectomy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of varicocelectomy on the DNA fragmentation index and other sperm parameters: a meta-analysis

Birowo

Wijaya

Atmoko

et al. 2020

Basic Clin. Androl.

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“…Combining with the results from the previous study, conclusions from the current meta-analysis strongly supported that varicocelectomy could significantly reduce sperm DNA fragmentation among clinical varicocele patients. Varicocele is a well-established cause of sperm DNA fragmentation, which has been shown to be not only associated with decreased fertility but also increased rates of miscarriage (Machen & Sandlow, 2019). All the evidence supported varicocelectomy conduction among patients with elevated sperm DFI.…”

Section: Discussionmentioning

confidence: 79%

Efficacy of varicocelectomy for sperm DNA integrity improvement: A meta‐analysis

2020

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Varicocele is common among male adolescents and adults. Varicocelectomy is the major means of varicocele repair. There is evidence that varicocelectomy could decrease sperm DNA fragmentation. However, studies evaluating the efficacy of varicocelectomy for sperm DNA integrity usually have a small sample size, and there is no up-to-date meta-analysis in this area. The present meta-analysis is to evaluate the

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“…29,30 There are other benefits that may result from treatment, including increased testosterone, and may be indicated for hypogonadism in the future, but data are limited at present. 31 There are variable data regarding treatment in pediatric and adolescent populations. Indications for treatment may include significant testicular volume asymmetry, sperm abnormalities, orchialgia, and failure of testicular development.…”

Section: Testicular Varicocelementioning

confidence: 99%

Sonographic Evaluation of Pelvic Venous Disorders

Brahmbhatt

Macher

Shetty

et al. 2021

Ultrasound Quarterly

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Pelvic venous disorders are a group of interrelated conditions characterized by venous incompetence. These conditions often manifest with nonspecific symptoms that overlap with many gynecological, gastrointestinal, and urologic diseases. Clinical diagnosis can be difficult, and imaging can play a vital role in differentiating etiology. Sonographic evaluation is often the first step in evaluating these symptoms. Special attention to possible underlying pelvic venous disorders can reveal characteristic findings, support diagnosis, and guide treatment.Here we review pelvic congestion syndrome, nutcracker syndrome, May-Thurner syndrome, and other venous disorders, with a specific focus on sonographic findings and considerations.

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Extended indications for varicocelectomy

Cited by 9 publications

References 58 publications

The effects of varicocelectomy on the DNA fragmentation index and other sperm parameters: a meta-analysis

The effects of varicocelectomy on the DNA fragmentation index and other sperm parameters: a meta-analysis

Efficacy of varicocelectomy for sperm DNA integrity improvement: A meta‐analysis

Sonographic Evaluation of Pelvic Venous Disorders

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