Longitudinal Study of Semen Quality in Adolescents with Varicocele: To Treat or Not?

Zampieri, Nicola; Corroppolo, Michele; Zuin, Veronica; Cervellione, Raimondo M.; Ottolenghi, A.; Camoglio, Francesco Saverio

doi:10.1016/j.urology.2007.07.061

Cited by 20 publications

(10 citation statements)

References 29 publications

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“…, 2008), it is suggested that preserving the testicular artery should be advised in cases where cremasteric and vasal arteries may be compromised (previous varicocelectomy, inguinal hernia repair, orchiopexy, previous vasectomy and vasectomy reversal) and in solitary testis or testicular hypotrophy (Lee et al. , 2007; Zampieri et al. , 2007b; Wu et al.…”

Section: Discussionmentioning

confidence: 99%

Preserved testicular artery at varicocele repair

Salem

Mostafa

2009

Andrologia

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Whether or not varicocele causes infertility is a contentiously debated issue. This study aimed to compare semen parameters and pregnancy rate in infertile males who underwent varicocelectomy with preserved or accidentally ligated testicular artery. Ninety-five infertile oligoasthenozoospermic patients with left-sided varicocele were subjected to subinguinal varicocelectomy with trial of preserving testicular artery. According to absence or presence of testicular artery in the histological excised pedicle the cases were divided into two groups; group 1 (n = 60) with preserved testicular artery and group 2 (n = 35) where the artery was accidentally ligated being not defined or injured. Semen analysis was carried out after 4, 8 and 12 months and post-operative pregnancy rate was assessed after 1 year. Serum follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone (T) were estimated pre- and post-operatively. Semen parameters (total sperm count, sperm concentration and sperm motility) showed significant increase post-operatively compared with pre-operative parameters but were comparable in both groups with no significant difference. Serum FSH, LH, T hormones and pregnancy rate (23.3% versus 22.9%) 1 year post-operatively showed no significant difference. It is concluded that accidental ligation of testicular artery has no deleterious effect on semen parameters during primary varicocele repair if the testicular arterial supply was not compromised.

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Section: Discussionmentioning

confidence: 99%

Preserved testicular artery at varicocele repair

Salem

Mostafa

2009

Andrologia

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“…These include discussions on which is the gold standard technique to reduce the onset of complications, the optimal age range to treat this pathology, which are the indicators to a real need for varicocele treatment and which are the success criteria for varicocelectomy. Although recent studies showed that testicular hypotrophy may be transitory, implying that it cannot be considered as an absolute indication to treatment, the evaluation of the grade of vein reflux may be a useful indicator for treatment (Zampieri et al ., , ; Cimador et al . (,b); Van Batavia et al ., ).…”

Section: Discussionmentioning

confidence: 98%

Varicocele treatment in paediatric age: relationship between type of vein reflux, surgical technique used and outcomes

Camoglio

Zampieri

2015

Andrologia

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Varicocele is the first andrological disease in adolescent males. The aim of this study was to report our experience with different techniques. We retrospectively analysed patients treated between January 2005 and January 2011. Inclusion criteria for the study were created. Patients were treated with different techniques based on the type of spermatic vein reflux detected on Doppler velocimetry. The following rates were considered as study endpoints: hydrocele rate, rate of relapses, rate of persistence and rate of testicular atrophy. During the study period, 522 surgical varicocelectomies were performed. Patients were treated with videolaparoscopy, open inguinal technique, subinguinal technique and one-trocar transumbilical technique. The laparoscopic and the subinguinal techniques showed a lower rate of hydrocele, and the laparoscopic technique had a lower rate of relapses. Choosing a technique based on the type of spermatic vein reflux can reduce the post-operative complications. The laparoscopic techniques had a lower rate of relapses with respect to other techniques.

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“…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: 99%

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

et al. 2013

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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.

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Longitudinal Study of Semen Quality in Adolescents with Varicocele: To Treat or Not?

Cited by 20 publications

References 29 publications

Preserved testicular artery at varicocele repair

Preserved testicular artery at varicocele repair

Varicocele treatment in paediatric age: relationship between type of vein reflux, surgical technique used and outcomes

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

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