Right subclinical varicocele: how to manage in infertile patients with clinical left varicocele?

Elbendary, Mohamed; Elbadry, Amr Arafa

doi:10.1016/j.fertnstert.2009.05.069

Cited by 50 publications

(36 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, it seemed that such thermal interaction between hemiscrota in the presence of left varicocele may have been due to proximity of the hemiscrota or intra-scrotal vascular shunts and were not related to systemic vascular control. 3,7 One of the healthy controls was misclassified as left varicocele as he presented a basal temperature of the left hemiscrotum about 1°C higher than the mean value of the healthy group. However, left varicocele group presented both higher r and h values (Fig.…”

Section: Discussionmentioning

confidence: 99%

Scrotal Thermoregulatory Model and Assessment of the Impairment of Scrotal Temperature Control in Varicocele

et al. 2010

View full text Add to dashboard Cite

Varicocele is defined as the pathological dilatation of the pampiniform plexus and scrotal veins with venous blood reflux. Varicocele may impair scrotal thermoregulation and spermatogenesis, even when present in asymptomatic forms. In this study, we use the control system theory to model scrotal thermoregulation in response to a standardized cold challenge in order to study the functional thermal impairment secondary to varicocele. The proposed model is based on a homeostatic negative feedback loop, characterized by four distinct parameters, which describe how the control mechanisms are activated and maintained. Thermal infrared images series from 49 young patients suffering from left varicocele and 17 healthy controls were processed. With respect to healthy controls, left varicocele patients presented higher basal scrotal temperature and faster recovery of the left hemiscrotum. The model indicated that varicocele alters local heat exchange processes among cutaneous layers and inner structures. The estimated model parameters help in the assessment of the scrotal thermoregulatory impairment secondary to the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Scrotal Thermoregulatory Model and Assessment of the Impairment of Scrotal Temperature Control in Varicocele

et al. 2010

View full text Add to dashboard Cite

show abstract

“…In a comparative study involving 104 infertile men, no difference was observed in performing bilateral versus left only retroperitoneal surgical repair for left clinical and right subclinical varicocele [78]. Elbendary and Elbadry [79] reported a prospective series of 145 men with the same description. In their aforementioned study, varicocelectomy was performed using an inguinal open technique.…”

Section: Subclinical Varicocele: a Point Of Debatementioning

confidence: 99%

A Critical Appraisal on the Role of Varicocele in Male Infertility

Miyaoka

Esteves

2012

Advances in Urology

View full text Add to dashboard Cite

Varicocele is a major cause of male infertility, as it may impair spermatogenesis through several distinct physiopathological mechanisms. With the recent advances in biomolecular techniques and the development of novel sperm functional tests, it has been possible to better understand the mechanisms involved in testicular damage provoked by varicocele and, therefore, propose optimized ways to prevent and/or reverse them. Up to now, there is still controversy involving the true benefit of varicocele repair in subfertile men as well as in certain specific situations such as concomitant contralateral subclinical varicocele or associated nonobstructive azoospermia. Also, with the continued development of assisted reproductive technology new issues and questions are emerging regarding the role of varicocelectomy in this context. This paper reviews the most recent data available on the pathogenesis, diagnosis, and management of varicocele with regard to male infertility.

show abstract

“…In cases of left clinical and right subclinical varicoceles, it has been reported that bilateral varicocele ligation is effective. [21][22][23][24] Pasqualotto et al 21 said that even a small, subclinical unrepaired varicocele continues to have a detrimental effect on bilateral testis function in a patient with a grade II-III left varicocele. In addition, the greater improvement in semen parameters and pregnancy outcome associated with bilateral varicocelectomy support the concept of a detrimental dose-effect of varicoceles on male fertility potential.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the greater improvement in semen parameters and pregnancy outcome associated with bilateral varicocelectomy support the concept of a detrimental dose-effect of varicoceles on male fertility potential. 23,24 However, several authors were opposed to the benefits of bilateral varicocelectomy for left clinical and right subclinical varicoceles. 25 There are several inevitable limitations in the present study.…”

Section: Discussionmentioning

confidence: 99%

Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study

et al. 2011

View full text Add to dashboard Cite

Abstract:We aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation-related pain (10-point visual analog pain scale), catch-up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery-related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch-up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.

show abstract

Right subclinical varicocele: how to manage in infertile patients with clinical left varicocele?

Cited by 50 publications

References 34 publications

Scrotal Thermoregulatory Model and Assessment of the Impairment of Scrotal Temperature Control in Varicocele

Scrotal Thermoregulatory Model and Assessment of the Impairment of Scrotal Temperature Control in Varicocele

A Critical Appraisal on the Role of Varicocele in Male Infertility

Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study

Contact Info

Product

Resources

About