Bilateral disease and intratesticular haemodynamics as markers of dyspermia in patients with subclinical varicocele: A prospective study

Tsampoukas, Georgios; Dellis, Athanasios; Papatsoris, Athanasios

doi:10.1080/2090598x.2019.1647676

Cited by 3 publications

(3 citation statements)

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“…Also, we examined the role of vein diameter on both sides and there was no significant difference between the groups. These results are in accordance with our previous study where no association was found between maximal vein diameter in men with SV and dyspermia (12). This does not sound surprising, as even in clinical forms, even grade seems to be inferior to reflux in terms of prediction of the results of varicocelectomy (25).…”

Section: Discussionsupporting

confidence: 93%

“…In young boys, pattern of grade I reflux helps stratify the risk for hypotrophy and assist the follow-up (27). In our previous study in adult men, the pattern of the reflux (lasting all the duration of the Valsava vs short-lasting reflux) had not been linked to dyspermia in adults patients with subclinical varicocele (12). Reflux is note- worthy though, and the shunt-type (continuous) reflux is strongly associated with testicular hypotrophy in adolescents (28), whereas prolonged reflux may also predict the outcome of varicocelectomy in adults (25).…”

Section: Discussionmentioning

confidence: 86%

“…The prevalence of BSV seems to be higher in older men, whereas the condition is associated with deterioration of semen quality, especially sperm motility, during a long follow-up (10,11). Previously, we had concluded that the presence of BSV has been associated with abnormal semen parameters in young men in comparison to unilateral SV (12). In this study, we followed a population of young men with BSV and asthenospermia in their spermiogram who did not desire fatherhood at time of presentation with a planned follow-up of 6 months.…”

Section: Introductionmentioning

confidence: 94%

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Role of total motile sperm count in the evaluation of young men with bilateral subclinical varicocele and asthenospermia

Tsampoukas

Dellis

Katsouri

et al. 2020

Arch Ital Urol Androl

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Introduction: In comparison to its clinical analogue, the subclinical varicocele represents a questionable entity and specific guidelines for the optimal management are lacking. In our previous study of patients with subclinical varicocele, we showed that bilateral condition is associated with risk of dyspermia. In the present study, we evaluated the risk of deterioration of semen quality in men with bilateral disease and impaired motility according to WHO criteria. Materials and methods: Men with bilateral subclinical varicocele, not desiring fatherhood at the time of presentation, were included in study. During initial evaluation, the number of Total Motile Sperm Count (TMSC) was calculated and the patients’ age, total testicular volume (TTV), maximum venous size and mean resistive index (RI) of the intratesticular arteries were recorded. We classified the participants in five classes according to the TMSC reading: class A-: TMSC < 5 x 106, class A: TMSC between 5-10 x 106, class B: TMSC between 10-15 x 106, class C: TMSC between 15-20 x 106, and class D: TMSC > 20 x 106 per ejaculate. The participants were seen after 6 months for a repeat spermiogram and physical examination. If clinical varicocele was diagnosed or a new abnormality in the spermiogram was noted, the participants were excluded from the study. The remaining patients were allocated to two groups according to the repeat TMSC reading: patients sub-classified into a lower class (group 1), and patients remaining at the same class (group 2). A comparative analysis was performed between two groups. Results: Nineteen men were included. Nine patients were subclassified (group 1). Three patients moved to A- class (< 5 x 106). Ten patients remained in the same class having no deterioration (group 2). Comparing the two groups, no statistically significant difference was recognized for age, TTV, maximum venous size on both sides, and mean RI (p > 0.05). However, the initial reading for TMSC was 14.57 x 106 in group 1, and 22.84 x 106 in group 2, respectively. This difference was statistically significant (p < 0.05). Additionally, in a paired analysis there was a significant difference in TMSC after 6 months (p < 0.05), too. Summary Conclusions: Young men with bilateral varicocele and asthenospermia seem to be at risk of deterioration in their semen quality after a follow-up of 6 months. The measurement of TMSC can unmask patients at risk, whereas men with the lowest readings seem to be at highest risk for deterioration. The possibility of a worsening sperm quality should be considered in the appropriate clinical context.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 94%

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Role of total motile sperm count in the evaluation of young men with bilateral subclinical varicocele and asthenospermia

Tsampoukas

Dellis

Katsouri

et al. 2020

Arch Ital Urol Androl

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The effect untreated right subclinical varicocele on the outcomes of contralateral left clinical varicocelectomy in infertile patients

Yılmaz,

Topcuoğlu,

Çakan

et al. 2024

Arch Ital Urol Androl

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Purpose: The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA). Materials and methods: Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up. Results: The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations. Conclusions: Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.

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Predictive parameters of the efficacy of varicocele repair: a review

Crafa,

Cannarella,

Condorelli

et al. 2024

Asian Journal of Andrology

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Abstarct Varicocele has a prevalence of 15% in the population and represents a primary cause of infertility in 40% of cases and a secondary cause in approximately 80% of cases. It is considered the major correctable cause of male infertility. Despite its high prevalence in the infertile population, a large number of patients with varicocele do not experience reproductive difficulties. For this reason, it is still highly debated which parameters could be used to predict which patients with varicocele will be most likely to benefit from its repair. The main international and European guidelines state that treatment should only be considered in infertile patients with abnormal sperm quality. However, these guidelines do not help physicians to identify which of these patients may benefit from the treatment. Therefore, this narrative review collects the evidence in the literature on the usefulness of some factors as predictors of improvement, highlighting how some of them may be effective in an initial selection of patients to be treated, while others are promising but further studies are needed. Finally, a brief consideration on the possible role of artificial intelligence is proposed.

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Bilateral disease and intratesticular haemodynamics as markers of dyspermia in patients with subclinical varicocele: A prospective study

Cited by 3 publications

References 53 publications

Role of total motile sperm count in the evaluation of young men with bilateral subclinical varicocele and asthenospermia

Role of total motile sperm count in the evaluation of young men with bilateral subclinical varicocele and asthenospermia

The effect untreated right subclinical varicocele on the outcomes of contralateral left clinical varicocelectomy in infertile patients

Predictive parameters of the efficacy of varicocele repair: a review

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