Varicocele in pediatric patients: comparative assessment of different therapeutic approaches

Pintus, Claudio; Matas, Màrian; Manzoni, Carlo; Nanni, Lorenzo; Perrelli, L

doi:10.1016/s0090-4295(00)00859-1

Cited by 64 publications

(46 citation statements)

References 21 publications

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“…Several mechanisms may be involved in the negative effect of varicocele on male infertility. These include elevated intrascrotal temperature, reflux of adrenal and renal metabolites through renal vein, hypoxia, and ischemia (15,16). A statistically significant deterioration in sperm count and motility throughout the follow-up period of untreated varicocele has been previously documented (17).…”

Section: Discussionmentioning

confidence: 99%

Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy?: a retrospective study

et al. 2011

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Objectives:The most common indication for treatment of varicocele is still male subfertility. The aim of this study was to explore the effect of infertility duration on semen parameters and spontaneous pregnancy rate after varicocelectomy. Materials and Methods:The medical records of 183 infertile patients with clinical varicocele were retrospectively reviewed. The patients were divided into three groups according to the duration of infertility (group I, 1-3 years, group II, 3-6 years and group III, > 6 years). Total sperm motility counts (TMCs) before and after varicocelectomy and spontaneous pregnancy rate among these groups were statistically compared. Results: The greatest changes, regarding preoperative and postoperative TMCs and spontaneous pregnancy rate were noticed between group I and III. Preoperative TMCs in group I and III was 15.2 ± 1.2, 7.8 ± 1.4, respectively (p < 0.05). Postoperative TMCs in group I and III was 33.7 ± 2.5, 25.2 ± 1.9, respectively (p < 0.05). An overall spontaneous pregnancy rate of 34.4% was achieved after inguinal varicocelectomy. The greatest spontaneous pregnancy rate was achieved in Group I (37.3%), and the lowest pregnancy rate in Group III (26.3%) (P < 0.05). Conclusions: Surgical varicocelectomy improves the total sperm motility counts especially in patients who have a TMCS more than 5 million and improves the spontaneous pregnancy rates. The improvement in the spontaneous pregnancy rates after varicocelectomy correlates negatively with the duration of infertility. Therefore, duration of infertility should be considered in treating a patient with a varicocele as a cause of infertility.

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Section: Discussionmentioning

confidence: 99%

Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy?: a retrospective study

et al. 2011

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“…Is that mean the testicular atrophy must be the testis loss all the spermatogenesis? Recent reports of laparoscopic Palomo procedure revealed favourable outcomes [17,18]. However, can it be considered as normal if the testis reveals normal or mild decreased volume after SVCD procedure?…”

Section: Discussionmentioning

confidence: 99%

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Tang

Gorgas²,

Zachariou

2007

Pediatr Surg Int

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Laparoscopic Fowler-Stephens and Palomo procedures are now commonly performed in children with high positioned intra-abdominal cryptorchidism and varicocele, respectively. During the procedures, the spermatic vessels are ligated and therefore the question of risk related to testicular atrophy is often raised. The long-term follow-up of the histology after the procedures is rare. In this study, we simulated a laparoscopic spermatic vessels clipping and division (SVCD) in a prepubertal rat model, and examined the histological alterations of the testes with regard to spermatogenic arrest between prepuberty and middle age. Thirty-day-old Wistar rats divided randomly into three groups underwent laparoscopic sham operation, unilateral SVCD and unilateral SVCD with additional contralateral orchiectomy, respectively. Histological investigations observed on semithin and paraffin sections were performed at seven different postoperative intervals between day 9 and day 540. We defined partial, most and complete spermatogenic arrest of the seminiferous tubules to correspond with mild, severe spermatogenic arrest and atrophy, respectively. Laparoscopic SVCD induced testicular spermatogenic arrest in a total of 85% of the operated testes with different severity; 27% of operated testes with mild or severe spermatogenic arrest were seen between puberty and middle age (day 45-540 postoperative), and their size was only slightly reduced. Of the operated testes, 51% showed atrophic signs with a striking decrease in size, and their contralateral testes revealed in all cases mild or severe spermatogenic arrest started as early as day 45 postoperatively. Parallel to the spermatogenic arrest, Leydig cell hyperplasia developed frequently in impaired testes, especially in those without contralateral testes, finally reaching a typical adenoma size. Laparoscopic SVCD in prepubertal rats could disturb spermatogenesis with differing severity in most cases. This impairment could persist from peripuberty to middle age, and even involve the contralateral testes, in the case of operated testes and show complete spermatogenic arrest. This study showed that laparoscopic SVCD may have high risk in compromising the operated testis.

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“…Failure was usually due to preservation of the periarterial plexus of fine veins along with the artery. In the existing literature, some studies reported that artery preservation during LPVx results in higher recurrence and/or persistence rates (3.5%-20%) than when the spermatic vessels were ligated (17,18).…”

Section: Discussionmentioning

confidence: 99%

Comparison of different ligation techniques in laparoscopic varicocelectomy*

Akın¹,

Ateş²,

Yücel³

et al. 2014

Turk J Med Sci

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IntroductionWheat quality is simply defined as its suitability for a given final product. For durum wheat, quality means its suitability for pasta processing. The quality of pasta products is strongly correlated with the physical and chemical properties of durum wheat. Kernel vitreousness, protein content and quality (proper gluten strength), milling properties (semolina yield and ash content), yellow pigment content, and activities of lipoxygenase (LOX), peroxidase (POD), and polyphenol oxidase (PPO) enzymes are among the well-documented quality parameters (Clarke et al. 1998;Borrelli et al. 1999;Troccoli et al. 2000;Morris 2004). Of these quality parameters, protein content and quality, yellow pigment content, and the activities of the oxidative enzymes are of vital importance for pasta quality, as they overwhelmingly determine the so-called al dente cooking characteristics and bright yellow color of pasta products (Troccoli et al. 2000;Aalami et al. 2007).However, protein content and gluten quality (including gliadin and glutenin proteins) are the 2 most important variables in determining pasta cooking properties (D'Edigio

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Varicocele in pediatric patients: comparative assessment of different therapeutic approaches

Cited by 64 publications

References 21 publications

Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy?: a retrospective study

Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy?: a retrospective study

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Comparison of different ligation techniques in laparoscopic varicocelectomy*

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