Surgical management of adolescent varicocele: Systematic review of the world literature

Raheem, Omer

doi:10.4103/0974-7796.115728

Cited by 20 publications

(15 citation statements)

References 53 publications

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“…Most cases of extra-testicular (obstructive) male infertility require surgical interventions. Varicoceles management involves surgical treatment, including laparoscopic procedures, embolisation and laser obliteration [48,49]. Available data demonstrate that the treatment of varicoceles results in satisfactory outcomes: improved quality of sperm is observed in 70-80% of men; however, there is a lack of improvement in 15-20% while deterioration occurs in about 5%.…”

Section: Objectivementioning

confidence: 99%

Infertility in the light of new scientific reports – focus on male factor

Szkodziak¹,

Woźniak²,

Czuczwar³

et al. 2016

Ann Agric Environ Med.

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Section: Objectivementioning

confidence: 99%

Infertility in the light of new scientific reports – focus on male factor

Szkodziak¹,

Woźniak²,

Czuczwar³

et al. 2016

Ann Agric Environ Med.

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“…Both types appear to be associated with cryptorchidism and Leydig cell tumors also with impaired spermatogenesis 23 . Lastly, color‐Doppler imaging has been extensively employed in the detection and evaluation of testicular VC, which has been associated with ipsilateral hypotrophy and infertility, although this association is still under debate 26,27 …”

Section: Introductionmentioning

confidence: 99%

Testicular ultrasound score: A new proposal for a scoring system to predict testicular function

et al. 2020

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Background Testicular ultrasound (US) is routinely employed in the evaluation of reproductive and sexual function. However, its use for characteristics other than testicular volume is hampered by a lack of information on the prognostic value of its findings, which to date have only been incorporated in a score proposed by Lenz et al in 1993. Objectives We sought to explore whether testicular US examination can predict the quality of spermatogenesis and provide information on testicular endocrine function. Materials and methods We retrospectively reviewed 6210 testicular US examinations, finally selecting examinations from 2230 unique men. The following variables were considered: bitesticular volume and testicular asymmetry, parenchymal echotexture, echogenicity and presence of microlithiasis, solid lesions and varicocoele. Concurrent fasting hormonal data were available for 1160 men, while 979 had a semen sample available from the same day as the US examination. Results We derived a new US score, termed TU score, that can predict both impaired spermatogenesis (AUC 0.73, sensitivity 72%, specificity 61%, P < .001) and hypogonadism (AUC 0.71, sensitivity 71%, specificity 53%, P < .001) more accurately than the Lenz's score. In a multivariate analysis, a reduced sperm composite index (defined as total spermatozoa × total motility × normal forms) was independently predicted by bitesticular volume and by inhomogeneous echotexture, while hypogonadism was independently predicted also by reduced echogenicity and presence of microlithiasis. Discussion and conclusions We describe the testicular US characteristics that are independently associated with impaired spermatogenesis and hypogonadism and propose the TU score as a simple screening method for use in subjects referred for testicular US.

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“…Oral propranolol, and intralesional therapies such as OK432 (derived from Streptococcus pyogenes and designed to incite an inflammatory reaction), have meant surgery is now much less common for vascular anomalies . Varicocele surgery, where performed, has moved from open to laparoscopic to endovascular . For all of these conditions, contemporary outcomes are better than historical ones.…”

Section: Minimising the Riskmentioning

confidence: 99%

Theatre of paediatric surgery

McBride

Holland

2015

J Paediatrics Child Health

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In the 50 years since the first edition of this journal, operative paediatric surgery has undergone radical change. Many of the most common instruments are unchanged, both as a testament to their utility and in recognition of past surgeons remembered eponymously. Surrounding that basic core of instruments, theatre has changed radically as new tools and techniques have arisen. Surgeons have come down from their pedestals, recognising surgery as a team sport rather than a solo performance. More than half of the current paediatric surgical trainees are women, a higher proportion than in any other craft group of the Royal Australasian College of Surgeons. The appearance, and rapid development, of laparoscopy is to many observers the most notable change in surgery over the last 50 years. Placed in its context though, it is simply the most prominent example of a frameshift in surgical thinking. The patient as a whole is now the focus, rather than just the disease. Recent developments are as much about minimising harm to normal tissues as they are about extirpating pathology. As a surgical maxim, 'Primum non nocere' is even more in evidence in 2015 than it was in 1965.

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Surgical management of adolescent varicocele: Systematic review of the world literature

Cited by 20 publications

References 53 publications

Infertility in the light of new scientific reports – focus on male factor

Infertility in the light of new scientific reports – focus on male factor

Testicular ultrasound score: A new proposal for a scoring system to predict testicular function

Theatre of paediatric surgery

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