Hydrodynamic Relationship between Color Doppler Ultrasonography Findings and the Number of Internal Spermatic Veins in Varicoceles

Kim, Tae Beom; Chang, Joo Hyun; Yoon, Sang Jin; Kim, Soo Woong

doi:10.3349/ymj.2012.53.2.386

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…35 cm in the right spermatic vein in the case of insufficient valves resulting in a hydrostatic pressure on the left of over 30 mmHg and on the right of more than 27 mmHg on the distal pampiniform plexus. Kim et al concluded that both the height of the blood column and the number and cross-sectional area of the branches of the pampiniform plexus are responsible for the increased pressures [12]. This results, as explained by the Bernoulli equation, in increased static pressure in the pampiniform plexus with simultaneously slower flow rates, with the pressure increasing as the number of branches and thus the cross-sectional area of the pampiniform plexus increase.…”

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confidence: 99%

Treatment of Benign Prostatic Hyperplasia by Occlusion of the Impaired Urogenital Venous System – First Experience

Strunk

Méier²,

Schild³

et al. 2014

Fortschr Röntgenstr

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Purpose: To effect regression of benign prostatic hyperplasia (BPH), Gat et al. (Andrologia 2008) proposed to occlude incompetent spermatic veins to reduce increased hydrostatic pressure on the prostatic venous plexus and prevent reflux with androgen rich blood from the testicles. Our aim was to implement this treatment strategy in clinical practice and to report about first results. Methods: Embolization of the spermatic veins was performed in 30 patients with BPH. In 16 patients, we obtained follow-up data from at least 6 months. The sonographic transabdominal prostatic volume, prostate-specific antigen (PSA) and peripheral total testosterone levels were determined before and 6 months after the intervention. Subjective symptomatology was assessed using standardized questionnaires (International Prostate Symptom Score [IPSS] and Quality of Life score [QoL]) before and 6 months after the procedure. Results: The age of all treated patients was 46???77 years. The age of the 16 patients who received follow-up was 51???77 years. IPSS (median 18 [IQR 20.75???14.50] vs. 9 [IQR 11.00???7.25], p?

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confidence: 99%

Treatment of Benign Prostatic Hyperplasia by Occlusion of the Impaired Urogenital Venous System – First Experience

Strunk

Méier²,

Schild³

et al. 2014

Fortschr Röntgenstr

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“…The number of spermatic veins ligated intraoperatively was correlated with pre-operative ultrasound findings. Maximal reflux velocity and total cross-sectional area of the affected testicular veins on ultrasound were found to accurately relate with the number of veins ligated during surgery (Kim et al, 2012). Regardless of whether such a relationship carries a diagnostic value, its clinical relevance is probably more important for the clinician.…”

Section: Discussionmentioning

confidence: 96%

Does the number of veins ligated during varicococele surgery influence post-operative semen and hormone results?

et al. 2016

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SUMMARYVaricocele is a well-established cause of male subfertility, which is directly proportional to its clinical grade. Although newer ultrasonic grading systems have taken into account the existence of pampiniform venous plexi, little is known about the clinical significance of the number of veins ligated during surgery. Very few undersized studies reported an influence which triggered the need to evaluate such association. This is a retrospective study of 378 patients who underwent left microsurgical subinguinal varicocoelectomy. Semen analyses and blood hormone studies performed pre-operatively were compared to those executed 6 months after surgery. Patients were divided into abnormal semen and normal semen groups based on their initial semen results. They were also subdivided according to the number of veins ligated intraoperatively into three groups: <5, 5-10, and >10 veins. Sperm count, total motility, and progressive motility were significantly increased in 62, 60.3, and 53.3% of patients post-operatively (p = 0.001), respectively. No significant differences in hormone levels were detected overall. Of the 378 patients, 332 had an abnormal semen analysis, while the remaining 46 patients had a normal result. Sperm count, total motility, and progressive motility significantly increased after varicocoelectomy in patients with an abnormal initial semen analysis (p = 0.001). In 48.7% of patients, 5-10 veins were ligated during surgery, whereas 28.3% had >10 and 23% had <5 ligated veins. No statistically significant differences were noted in the initial or the follow-up results among the number of vein subgroups. Varicocele ligation improves patients' fertility potential. This improvement, however, is not influenced by the number of veins ligated intraoperatively. Clinical grading maintains its superiority in the evaluation of varicocele patients.

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“…However, the greatest improvement was seen in men with grade II rather than grade III varicocele. They suggested that the definite relationship still needs to be clarified ( 24 ). Although conflicting results are present, it is still considered that individual sperm parameter is not diagnostic for infertility, as a normal count of motility may not result in a higher chance of pregnancy ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…Shindel et al reported that grade II varicocele benefited the most regarding sperm morphology, where marked improvements were observed one year after varicocelectomy. However, the number of the ligated vein was not predictive of this improvement ( 24 ). Majzoub et al also reported no significant change in sperm volume obtained from the pre and postoperative semen analysis, regardless of the number of ligated veins ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

The Influence of Number of Ligated Veins in Varicocele Patients Undergoing Microsurgical Varicocelectomy in Postoperative Pain and Sperm Parameters Outcome

Syarief,

Rahman,

Setiawan

et al. 2023

Med Arch

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Background: The influence of the number of veins that should be ligated in varicocele surgery on postoperative pain and testicular function is not clearly understood. Objective: The aim of this study was to investigate the number of Internal Spermatic Vein (ISV) ligated in postoperative pain and sperm parameters outcome. Methods: Relevant studies were collected and systematically reviewed from Medline, Scopus, and Cochrane databases. This study followed the PRISMA guideline. The mean difference (MD), odds ratio (OR), and 95% confidence intervals (CIs) were measured in the assessment of the outcome. Revman 5.4 was used in data analysis. Results: The pooled meta-analysis demonstrated that complete pain resolution was significantly higher in patients undergoing varicocelectomy procedures with more than ten vein numbers ligated with OR 1.92, 95% CI (1.03, 3.60). Improvement of sperm parameters of change in sperm concentration was also significantly observed in patients with more than ten vein numbers ligated MD 32.79, 95% CI (23.13, 42.45). However, the number of veins ligated was not associated with the change in sperm motility MD 9.69 with 95% CI (-12.32, 31.71). Conclusion: The number of veins ligated intraoperatively determined pain relief and sperm concentration improvement. This study showed that varicocelectomy results improved with greater ISV ligation.

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Hydrodynamic Relationship between Color Doppler Ultrasonography Findings and the Number of Internal Spermatic Veins in Varicoceles

Cited by 6 publications

References 29 publications

Treatment of Benign Prostatic Hyperplasia by Occlusion of the Impaired Urogenital Venous System – First Experience

Treatment of Benign Prostatic Hyperplasia by Occlusion of the Impaired Urogenital Venous System – First Experience

Does the number of veins ligated during varicococele surgery influence post-operative semen and hormone results?

The Influence of Number of Ligated Veins in Varicocele Patients Undergoing Microsurgical Varicocelectomy in Postoperative Pain and Sperm Parameters Outcome

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