Internal spermatic vein diameter and age at operation reflect the response to varicocelectomy

Shiraishi, Koji; Takihara, Hiroshi; Naito, Katsusuke

doi:10.1046/j.1439-0272.2001.00452.x

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…The effectiveness of this surgical procedure has been confirmed in palpable or large varicocele. However, even subclinical varicocele shows remarkable postoperative improvement, and several studies have shown that the improvements in testicular histology 10 and spermiogram 11 are not related to varicocele size. In the era of ART, many urologists and andrologists consider that the purposes of varicocele treatment are to achieve patient satisfaction and cost‐effectiveness by natural pregnancy or IUI instead of IVF or ICSI.…”

Section: Role Of Sperm Factors In Icsimentioning

confidence: 99%

Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology

2012

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Abbreviations & Acronyms 4-HNE = 4-hydroxy-2-nonenal 8-OHdG = 8-hydroxy-2′-deoxyguanosine ART = assisted reproductive technology CCM = cerebral cavernous malformation CREM = cyclic adenosine 3′,5′-monophosphate response element modulator ELV = experimental left varicocele eNOS = endothelial nitric oxide synthase GDNFa1 = glial cell line-derived neurotropic factor receptor a1 GSR = glutathione reductase GPX = glutathione peroxidase GST = glutathione S-transferase HIF1 = hypoxia-inducible factor 1 HO-1 = heme oxygenase 1 ICSI = intracytoplasmic sperm injection IL-1 = interleukin-1 iNOS = inducible nitric oxide synthase IUI = intrauterine insemination IVF = in vitro fertilization MDA = malondialdehyde nNOS = neuronal nitric oxide synthase NO = nitric oxide PDRN = polydeoxyribonucleotide PCNA = proliferating cell nuclear antigen PN = pronuclear O2 -= superoxide anion ROS = reactive oxygen species RNS = reactive nitrogen species SOD = superoxide dismutase TUNEL = terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling VEGF = vascular endothelial growth factor Abstract: Varicocele is the most common and treatable cause of male infertility. Studies of a rat experimental left varicocele model and human testicular biopsy samples have shown the involvement of various factors in its pathophysiology. Among them, oxidative stress plays a major role in impairing spermatogenesis and sperm function. Therefore, in addition to palpation, scrotal ultrasonography and color Doppler ultrasound , evaluation of testicular oxidative stress (e.g. scrotal temperature is a surrogate parameter) is recommended to enable diagnosis and suitable treatment of varicocele. Varicocelectomy increases the fertilization, pregnancy and live birth rates, indicating improved sperm function; it is therefore important even in couples undergoing intracytoplasmic sperm injection. Routine sperm-function tests are warranted to monitor the sperm quality after varicocelectomy and consequent improvement in the outcomes of assisted reproductive technology. Furthermore, the indications of varicocelectomy in assisted reproductive technology should be widened.Key words: assisted reproductive technologies, oxidative stress, varicocele. Role of sperm factors in ICSIVaricocele is the most common cause of male infertility. Its prevalence is notably high (~40%) in couples with male factor infertility compared with the general population (Յ20%).1 While debating the pathophysiology of varicocele, its influence on infertility treatment should be considered. Twenty years ago, we reviewed that varicocele causes spermatogenic disorder, and attempted to detect and treat as many cases as possible. 2 In the 1990s, the widespread application of ICSI lowered the importance of varicocele treatment. Furthermore, the usefulness of varicocele treatment itself was regarded as doubtful. 3,4 In contrast, two recent meta-analyses have shown that varicocelectomy significantly improves sperm concentration and motility in infertile men with palpable varicocel...

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Section: Role Of Sperm Factors In Icsimentioning

confidence: 99%

Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology

2012

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“…Metin et al (1991) reported varicocele in 100% of cases with a 5–6 mm vein diameter; in 50% if 3–4 mm; and in 16% if 1–2 mm. Shiraishi et al (2001) positively correlated mean vein diameter with its grade (subclinical: 2.40 mm; grade I: 2.74 mm; grade II: 3.7 mm; grade III: 4.38 mm). Kocakoc et al.…”

Section: Discussionmentioning

confidence: 91%

Radiologically assessed testicular changes in infertile males with varicocele

2011

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The aim of this study was to assess vascular disturbances in the testis of infertile males associated with varicocele. In total, 124 consecutive male subjects were divided into the following groups: healthy fertile controls (n = 10), Gp1 (n = 28); infertile males with subclinical varicocele, Gp2 (n = 26); infertile males with grade I left varicocele, Gp3 (n = 28); infertile males with grade II left varicocele and Gp4 (n = 32); infertile males with grade III left varicocele. They were subjected to colour duplex for pampiniform plexus and scrotal scintigraphy. There was significant decrease in arterial blood velocity, testicular arterial diameters and testicular perfusion especially in high grade varicocele compared with healthy controls. The mean vein diameter demonstrated significant negative correlation with arterial diameter, arterial blood velocity, perfusion index, testicular size and significant positive correlation with perfusion index. The mean testicular size demonstrated significant positive correlation with arterial blood velocity, perfusion index and nonsignificant correlation with arterial diameter. It is concluded that there are significant decreases in testicular volume, testicular perfusion, blood velocity and testicular artery diameter in infertile males with varicocele.

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“…In another study, patients were subdivided into those <30 years and those ≥30 years to determine the effect of age on varicocelectomy results. The authors indicated that patient age at the time of the operation was of greater value for predicting the treatment outcome of a varicocelectomy [25]. In contrast to that report, the reproductive outcomes of infertile couples with a clinical varicocele and advanced paternal age were evaluated by Zini et al [26].…”

Section: Discussionmentioning

confidence: 98%

The Effect of Age on Semen Quality and Spontaneous Pregnancy Rates in Patients who Treated with Microsurgical Inguinal Varicocelectomy

Fırat¹,

Erdemır²

2020

Cureus

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The aim of this study is to evaluate whether pregnancy rates or semen parameters are affected due to male or female age after microsurgical varicocelectomy. Methods A total of 293 infertile men who underwent microsurgical inguinal varicocelectomy were divided into three groups according to age: group 1, patients and their spouses ≥35 years old (n = 46); group 2, patients ≥35 years old and their spouses <35 years old (n = 34); and group 3, patients and their spouses <35 years old (n = 213). Preoperative and postoperative semen parameters and pregnancy rates were compared. Results The median ages of the patients in groups 1, 2, and 3 were 41, 35.50, and 28 years, respectively. The median ages of the spouses were 36 (35-38 years), 30 (21-34 years), and 25 (18-32 years) years, in groups 1, 2, and 3, respectively. Total motile sperm count (TMC) significantly increased in all groups after varicocelectomy (P < 0.05). Pregnancy rates after varicocelectomy was higher in group 3 compared to groups 2 and 3, but the differences were not significant (P = 0.133). Conclusions According to these results we can say that male and female ages were not negative factors in terms of pregnancy rates.

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Internal spermatic vein diameter and age at operation reflect the response to varicocelectomy

Cited by 10 publications

References 24 publications

Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology

Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology

Radiologically assessed testicular changes in infertile males with varicocele

The Effect of Age on Semen Quality and Spontaneous Pregnancy Rates in Patients who Treated with Microsurgical Inguinal Varicocelectomy

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