Potential role of imaging in assessing harmful effects on spermatogenesis in adult testes with varicocele

Abstract

Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging (MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.

The use of diffusion-weighted MR imaging in the functional assessment of the testes of patients with clinical varicocele

“…Testicular arterial blood flow is significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis (Tsili et al, ). It is hypothesised that impaired venous drainage leads to increase in testicular veins pressure.…”

“…Varicocele is the most common andrological disorder among adolescents and adult males with an incidence of 15%–20%. It is associated with 35% and 69% of primary and secondary infertility cases respectively (Baigorri & Dixon, ; Gat et al, ; Tsili et al, ).…”

Imaging seminiferous tubules – a 9.4T MRI mouse model

“…MRI/MRS may also be valuable clinical tools. For example, MRI can be used in humans to visualise intratesticular lesions (22-24), testicular tumours (25), torsion (21, 26), varicoceles (27, 28) and testicle location (29) at common clinical MR field strengths. Reduction in testicular size, epididymis diameter or seminiferous tubule diameter (30) may be markers of disrupted spermatogenesis, and the size of either could thus potentially be used as an indicator of pathology.…”

Protective effect of ghrelin on testicular damages caused by chronic hypoxia in rats: A histopathological study

“…Despite the controlled environmental conditions, harmful factors such as varicocele, testicular torsion and environmental impacts of oxygen deficiency (hypoxia) can cause changes in the blood flow, nutrition and oxygenation of male germ cells as well negative effects on the function of these cells and thus lead to reduced fertility or infertility (Liao et al., ; Tsili et al., ; Verratti et al., ). Previous studies have expressed that DNA damages and apoptosis of germ cells are common features found in hypoxia, varicocele and testicular torsion (Liao et al., ).…”

“…According to previous studies, hypoxia can reduce fertility in humans and rats. Clinical and experimental studies have indicated that hypoxia can reduce the number and motility of sperm, cause degenerative changes and increase the apoptosis of germ cells in seminiferous tubules (Liao et al., , ; Reyes et al., ; Tsili et al., ). In addition, the previous study showed that hypoxia causes functional and histopathological changes in the testis of neonatal rats (Liu & Du, ).…”