Varicocele: a bilateral disease

Gat, Yigal; Bachar, Gideon; Zukerman, Zvi; Belenky, Alexander; Gornish, Michael

doi:10.1016/j.fertnstert.2003.08.010

Cited by 153 publications

(110 citation statements)

References 28 publications

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“…However, the percentages of bilateral cases in our study (54.2% in MIV and 64.3% in MSIV) were obviously higher than their results (18% in MIV and 14% in MSIV). However, our results were consistent with those of Gat et al [21], from which high bilateral prevalence (80.7%) could be seen in infertile males, and they considered varicocele to be a bilateral disease. Actually, dilation of the right testicular vein is a common finding in patients or animals with left varicocele.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Two Approaches in Microsurgical Varicocelectomy in Chinese Infertile Males

Pan

Zhang

et al. 2013

Urol Int

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Objective: To compare the outcomes of two approaches (inguinal and subinguinal) of microsurgical varicocelectomy (MV) in Chinese infertile men. Patients and Methods: 120 infertile men who met the inclusion criteria were randomly assigned to two groups and operated with MV using different approaches. The outcomes and complications were then compared. Results: The two groups were similar in all aspects except the percentage of patients using analgesic at 27 h postoperatively (57.6% in the inguinal group, 37.5% in the subinguinal group; p < 0.05). Spontaneous pregnancy was achieved at a ratio of 33.9% in the inguinal group and 30.4% in subinguinal group. The median values of semen parameters were significantly improved postoperatively in both groups. Conclusions: Both approaches are effective methods in the repair of varicocele in infertile men, but more analgesic medication at the first day after operation may be required in inguinal group.

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Section: Discussionsupporting

confidence: 93%

Comparison of Two Approaches in Microsurgical Varicocelectomy in Chinese Infertile Males

Pan

Zhang

et al. 2013

Urol Int

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“…The one-way valves in the ISV facilitate venous blood flow upwards against the gravity, since there is no active pump in the vertical testicular drainage. Several studies have demonstrated that the destruction of one-way valves is a bilateral vascular disease (Gat et al, 2003(Gat et al, , 2004a, with a prevalence that increases with age (Canales et al, 2005); reaching over 75% at the age of 70 (Levinger et al, 2007). Without competent one-way valves the ISVs cease to function as drainage systems and become passive vessels.…”

Section: Discussionmentioning

confidence: 99%

“…All patients assigned a written informed consent to participate in the study prior to the procedure. The treatments were performed by a highly experienced interventional radiologist in a digital fluoroscopic suite equipped with a 45/90 degree tilt table (Gat et al, 2003(Gat et al, , 2004a.…”

Section: Methodsmentioning

confidence: 99%

Reversal of benign prostate hyperplasia by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment

et al. 2008

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“…Varicocele, defined by the presence of dilated veins in the pampiniform plexus with blood reflux [1], is considered the main treatable cause of male infertility [2,3]. Varicoceles are detected in 15 % of the general adolescent and adult male population.…”

Section: Introductionmentioning

confidence: 99%

Alterations in the proliferative/apoptotic equilibrium in semen of adolescents with varicocele

Belardin

Giudice

Camargo

et al. 2016

J Assist Reprod Genet

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Purpose To verify if the presence of varicocele (grades II and III) with and without seminal alterations, using the 5 th centile cutoff values in table A1.1 of the World Health Organization (WHO, 2010) manual, alters the seminal plasma levels of proteins DNASE1 (deoxyribonuclease-1) and IGFBP7 (Insulin-like growth factor-binding protein 7), which are related to apoptosis regulation and cell proliferation, respectively, demonstrating that these proteins are important for correct spermatogenesis. Methods This cross sectional study was performed at the Sao Paulo Federal University Paulo between May 2014 and April 2016. A total of 61 male adolescents were included in this study, of which 20 controls without varicocele (C), 22 with varicocele and normal semen analysis (VNS) and 19 with varicocele and altered semen analysis (VAS). Seminal plasma from each patient was used for Western blotting analysis of individual protein levels. Values of each protein were normalized to a testicular housekeeping protein (PARK7-protein deglycase DJ-1). Results Levels of IGFBP7 protein are increased in varicocele. Levels of DNASE1 are progressively decreased in varicocele (lower in varicocele and normal semen analysis, lowest in varicocele and altered semen analysis) when compared to adolescents without varicocele. DNASE1 levels are positively correlated with sperm concentration and morphology (correlation values of 0.400 and 0.404, respectively; p values of 0.001 and 0.001, respectively). Conclusion In conclusion, in adolescents, seminal plasma levels of IGFBP7, responsible for proliferative activity, are increased in varicocele grades II and III, and DNASE1, responsible for apoptosis regulation, are lower in varicocele, lowest in varicocele and low semen quality. These proteins demonstrate molecular alterations brought upon by varicocele. Moreover, DNASE1 is capable of discriminating a varicocele that causes alterations to semen quality from one that does not. We propose that the initial response of varicocele is to increase proliferative activity which, if followed by regulation of apoptosis, may lead to the ejaculation of a population of sperm that are in accordance with WHO cutoff values but, in the presence of dysregulated apoptosis, leads to lower sperm concentration and morphology.

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Varicocele: a bilateral disease

Cited by 153 publications

References 28 publications

Comparison of Two Approaches in Microsurgical Varicocelectomy in Chinese Infertile Males

Comparison of Two Approaches in Microsurgical Varicocelectomy in Chinese Infertile Males

Reversal of benign prostate hyperplasia by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment

Alterations in the proliferative/apoptotic equilibrium in semen of adolescents with varicocele

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