Treatment of varicocele in children and adolescents: A systematic review and meta-analysis from European Association of Urology/European Society for Paediatric Urology Guidelines Panel

Silay, M.S.; Hoen, L.A. ’t; Quadackaers, J.; Undre, S.; Bogaert, G.; Kocvara, R.; Nijman, R.J.M.; Radmayr, C.; Tekgul, S.; Stein, R.

doi:10.1016/s1569-9056(19)31533-7

Cited by 4 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Benefits and harms of surgical or radiologic intervention versus conservation in children varicocele are controversial. Several systematic reviews, meta-analysis, and clinical trials have proven that treatment has moderate effect on testicular volume, semen parameters, and sperm concentration [4,[10][11][12]. Sclerotherapy is an acceptable approach in treating varicocele.…”

Section: Discussionmentioning

confidence: 99%

“…Staining the lymphatic vessels with methylene blue was introduced in 2004 to help avoid hydrocele formation in lymphatic sparing varicocelectomy [17]. No specific surgical technique is now set to be the best, although, generally, the trend goes toward least invasive techniques [12]. Sub-inguinal microscopic varicocelectomy was regarded to be one of the best techniques for some time [18].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Needlescopic lymphatic-sparing varicocelectomy in children using a mediflex needle: a new simplified technique

et al. 2020

View full text Add to dashboard Cite

Aim In this study we present a new technique for Needlescopic dye-assisted lymphatic-sparing Varicocelectomy (NV) in children using 14-gauge fascial closure needles (Mediflex ® , D-1001 New York, USA), (MedN) and a Vascular Access Canula (VAC). Patients and methods Forty-two male children with 55 varicoceles (13 bilateral, 29 unilateral) underwent NV. According to the Dubin grading system, nine varicoceles were grade II (16%) and 46 (84%) varicoceles were grade III. Testicular lymphatics were demarcated by injection of 2 ml methylene blue. Results Fifty-five needlescopic dye-assisted lymphatic-sparing varicocelectomy were performed on 42 male children. Patients' age ranged between 8 and 16 years (mean 11.9 ± 3 years). The mean operative time was 32.6 ± 9.4 min for bilateral cases, and 21 ± 3.2 min for unilateral cases. All patients discharged home at the same day of surgery. There were no intraoperative complications. There was no conversion to either open or multiport laparoscopic technique. In cases of left varicocele, the median testicular volumes difference decreased from 0.2645 ± 0.17 preoperatively to 0.126 ± 0.08 post operatively (P < 0.001). In bilateral cases, the median testicular differences of right and left testicular volumes decreased from 0.074 ± 0.03 preoperatively, to 0.026 ± 0.02, postoperatively, and from 0.238 preoperatively ± 0.11, to 0.1125 ± 0.06, post operatively, (P < 0.05), respectively. Family satisfaction was achieved in 98% of cases. Excellent cosmetic appearance were obtained. Conclusion This present method of single-port needlescopic dye-assisted varicocelectomy in children using MedN proved to be a feasible, safe, and an acceptable technique which further improves the cosmetic appearance and may be considered as an alternate minimally invasive varicocelectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Needlescopic lymphatic-sparing varicocelectomy in children using a mediflex needle: a new simplified technique

et al. 2020

View full text Add to dashboard Cite

show abstract

“…7 However, in their meta-analysis Silay et al suggest that improvement in pain attributed to varicocele following repair may be seen in up to 100% of patients, although data are limited. 8 It does seem to be the case that correction of a varicocele where the left testis is ≥20% (or ≥2ml) smaller than the right side will lead to an improvement in semen parameters and a catch-up testicular growth, but no data reliably support a functional benefit. 8 It is the view of the author that adolescents who present with a varicocele need to be assessed, testicular volume measured, with follow-up monitoring for 12-18 months.…”

Section: Varicocelementioning

confidence: 99%

“…8 It does seem to be the case that correction of a varicocele where the left testis is ≥20% (or ≥2ml) smaller than the right side will lead to an improvement in semen parameters and a catch-up testicular growth, but no data reliably support a functional benefit. 8 It is the view of the author that adolescents who present with a varicocele need to be assessed, testicular volume measured, with follow-up monitoring for 12-18 months. If the patient is over 16 years of age, they should be offered a semen analysis to assess fertility potential -although it is important to remember that semen analysis has considerable variability at this age and may improve with time.…”

Section: Varicocelementioning

confidence: 99%

Five common urological problems affecting adolescent men

Tregunna¹,

Wood

2021

Trends Urol & Men's Health

View full text Add to dashboard Cite

show abstract

“…Microsurgical varicocelectomy can also improve sperm retrieval rates in azoospermic patients suffering from varicocele and promote pregnancy and live birth rates in oligospermic patients with varicocele [8]. However, although varicocelectomy can improve sperm quality and clinical outcomes, the precise mechanisms that underlie these effects have yet to be elucidated [9]. Furthermore, the outcome of microsurgical treatment cannot be predicted effectively and despite the application of microsurgery, approximately 30-40% of patients show no improvements in their sperm parameters [10].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Varicocele and Microsurgical Varicocelectomy on Semen Quality, as Determined by Metabolic Analysis

Zhang

Deng

Liu

et al. 2021

Preprint

View full text Add to dashboard Cite

The influence of varicocele and microsurgical varicocelectomy on semen quality remains unclear. No previous study has investigated the relationship between semen metabolism and the abnormalities in reproductive function caused by varicocele. Here, we used the non-targeted and targeted metabolic analysis to investigate the different metabolites in seminal plasma within normal, varicocele, and varicocelectomy groups. We clearly showed that varicocele significantly affects sperm metabolism, and microsurgical varicocelectomy can reverse this metabolic abnormality. Moreover, we characterized the landscape of three dipeptides in the seminal plasma of patients with varicocele that have not been identified previously in human tissues or biofluids. Interestingly, the levels of these three dipeptides decreased after microsurgical varicocelectomy coincident with an improvement in semen quality. Western blotting confirmed the downregulation of DPEP3 (dipeptidase 3) in the varicocele group and the upregulation of DPEP3 in the varicocelectomy group. Furthermore, we found that eight metabolites may be helpful to distinguish varicocele patients from normal subjects. Our results can be applied to earlier diagnosis or to predict the outcome of microsurgery for varicocele.

show abstract

Treatment of varicocele in children and adolescents: A systematic review and meta-analysis from European Association of Urology/European Society for Paediatric Urology Guidelines Panel

Cited by 4 publications

References 18 publications

Needlescopic lymphatic-sparing varicocelectomy in children using a mediflex needle: a new simplified technique

Needlescopic lymphatic-sparing varicocelectomy in children using a mediflex needle: a new simplified technique

Five common urological problems affecting adolescent men

The Influence of Varicocele and Microsurgical Varicocelectomy on Semen Quality, as Determined by Metabolic Analysis

Contact Info

Product

Resources

About