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Wang L, Yang Q, Xie X, Dou K. Microscopic internal spermatic vein-inferior epigastric vein anastomosis for the treatment of left varicocele: A case report and review of the literature. Asian J Surg 2023; 46:3963-3964. [PMID: 37130776 DOI: 10.1016/j.asjsur.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/02/2023] [Indexed: 05/04/2023] Open
Affiliation(s)
- Lei Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China; Department of Andrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital & Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Qi Yang
- Department of Andrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital & Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xiaoyue Xie
- Department of Andrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital & Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Ke Dou
- Department of Andrology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital & Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China.
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2
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Alfozan M. Effect of Varicocelectomy on Serum Follicle-Stimulating Hormone and Testosterone; The Interrelationship Between Hormonal Variables. Res Rep Urol 2023; 15:47-53. [PMID: 36721463 PMCID: PMC9884447 DOI: 10.2147/rru.s383114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Purpose The present study was conducted to analyze the effect of varicocelectomy on serum follicle-stimulating hormone (FSH) and testosterone. The interrelationship between seminal and hormonal variables is also investigated. Patients and Methods A prospective cohort study was conducted on patients of the urology clinic from 2012 to 2017. The study was conducted in the Security Forces Hospital, in Riyadh, Saudi Arabia. Infertile patients who had already undergone the FSH examination and testosterone twice were included in the study. Statistical Package for Social Sciences (SPSS) version 21.0 was used to analyze the data. Results A total of 186 patients were studied which reveals that the age group of 21-30 years was higher than other age groups 80 (43%), micro varicocelectomy was performed in 138 (74%) of patients and 79 (47%) patients had one-year infertility. The study assessed the effect of varicocelectomy on sperm count and motility serum FSH, testosterone, luteinizing hormone (LH), and prolactin, and it was found that none of the variables showed significant association after varicocelectomy, except for luteinizing hormone (P-value = 0.014). Testosterone levels in patients who had FSH ≤10 were also evaluated and it was found that the level of testosterone was increased with a decreased level of FSH (P-value = 0.005). Conclusion It was concluded from our results that after varicocelectomy, those patients who had FSH levels ≤10 were found to have increased testosterone levels. LH was also found to be significant; however, other hormones were not found to be significant. This may occur due to the reason that we have the majority of the participants in the age group 21-30. Further prospective studies are needed to evaluate the association with ample sample size.
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Affiliation(s)
- Mohammed Alfozan
- Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, 11942, Saudi Arabia,Correspondence: Mohammed Alfozan, Email
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Lu X, Han H, Zhang ZB, Chen H, Huang X, Zhang R. The Application Effect of Jiawei Sanyu Shengjing Decoction Combined with High Ligation of the Spermatic Vein in Varicocele Male Infertility Patients. Appl Bionics Biomech 2022; 2022:2629140. [PMID: 36032045 PMCID: PMC9410973 DOI: 10.1155/2022/2629140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To analyze the application effect of Jiawei Sanyu Shengjing decoction combined with high ligation of the internal spermatic vein in male infertility patients with varicocele (VC). Methods 106 male infertility patients with VC treated in our hospital from December 2018 to March 2019 were selected as examples. According to the length of stay, they were divided into the control group and observation group, with 53 cases in each group. High ligation of the internal spermatic vein was performed in both groups. On this basis, the observation group was treated with modified Sanyu Shengjing decoction, and the therapeutic effects of the two groups were compared. Results The effective rate of 94.34% in the observation group was higher than 79.25% in the control group (P < 0.05). After treatment, the serum index level and sperm deformity rate in the observation group were lower than those in the control group, and the semen density and sperm activity were higher than those in the control group (P < 0.05). Conclusion The treatment of VC male infertility with modified Sanyu Shengjing decoction combined with high ligation of the internal spermatic vein can effectively improve the number of sperm and reduce the density of semen.
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Affiliation(s)
- Xiangpeng Lu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, China
| | - Hao Han
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, China
| | - Zhi Biao Zhang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, China
| | - Hao Chen
- Heilongjiang Traditional Chinese Medicine Hospital, China
| | - Xingru Huang
- Heilongjiang Traditional Chinese Medicine Hospital, China
| | - Rui Zhang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, China
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Han L, Xiang S, Rong B, Liang Y, Zhao S. Verbascoside attenuates experimental varicocele-induced damage to testes and sperm levels through up-regulation of the hypothalamus-pituitary-gonadal (HPG) axis. PHARMACEUTICAL BIOLOGY 2021; 59:715-722. [PMID: 34148492 PMCID: PMC8216254 DOI: 10.1080/13880209.2021.1933085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
CONTEXT Verbascoside (VB), which is found in many medicinal plant families, exhibits biological activities in various diseases. However, its effects on varicocele (VCL)-induced damage remain unknown. OBJECTIVE To investigate the effects and mechanism of VB on experimental rats with varicocele (VCL)-induced damage. MATERIALS AND METHODS Sixty sexually mature male Sprague-Dawley (SD) rats were divided into six groups (n = 10): control, control-sham, VCL-vehicle (normal saline), and VCL + VB groups (50, 100, and 200 mg/kg/day, intraperitoneally). After 4 weeks of VB treatment, all animals were sacrificed, and the body and testicular weight, sperm quality parameters, histopathology, antioxidant status, and hormone levels were tested. The levels of gonadotropin-releasing hormone (GnRH) and gonadotropin-inhibitory hormone in the hypothalamus were detected by western blot. RESULTS Compared with the VCL-vehicle group (41.14%), administration of VB significantly increased the sperm viability (59.29, 65.45, 84.93%). VB groups showed higher Johnson's score (3.57 ± 0.15, 4.71 ± 0.26, 7.93 ± 0.37) than VCL-vehicle group (2.72 ± 0.24). Antioxidant status and hormone levels alterations were also observed. Meanwhile, the mean number of apoptotic tubules (8.15 ± 0.96, 6.61 ± 1.05, 2.17 ± 0.08) and apoptotic index showed a marked decrease. Compared with the VCL-vehicle group (0.21 ± 0.09), the VB groups (0.36 ± 0.07, 0.42 ± 0.06, 0.88 ± 0.10) showed considerable increases in GnRH. DISCUSSION AND CONCLUSIONS VB has protective effects on reproductive organs and VB may be therapeutically useful in the treatment of varicocele through up-regulation of the HPG axis.
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Affiliation(s)
- Letian Han
- The First Clinical School, Shandong University of Traditional Chinese Medicine, Jinan, China
- Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shan Xiang
- The First Clinical School, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Baohai Rong
- Department of General Surgery, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yanchen Liang
- Department of Orthopedics, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shengtian Zhao
- Department of Urology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of surgical treatment options for male infertility including varicocelectomy, treatment of ejaculatory duct obstruction, vasovasostomy, and sperm extraction, and to review recent advances in techniques and technologies that may improve operative outcomes. RECENT FINDINGS Microscopic subinguinal varicocelectomy has been shown to have the highest success rates with lowest rates of complications, and may be facilitated by the use of Doppler, indocyanine green angiography, and the 4K3D operating video microscope. The standard treatment for ejaculatory duct obstruction by transurethral resection of the ejaculatory ducts has changed little over time, but vesiculoscopy may allow for temporary dilation of an obstruction to allow for natural conception, while also offering diagnostic capabilities. Use of the robotic platform has gained popularity for vasectomy reversals but controversy remains regarding the cost-effectiveness of this option. Recently, a reinforcing suture technique has been described for vasovasostomy to minimize anastomotic breakdown and reversal failure. Finally, gray-scale and color-enhanced ultrasound may improve ability to predict successful sperm retrieval during extraction procedures. SUMMARY Though the fundamentals of surgical treatment options for male infertility have changed little with time, technological advancements have contributed to improved surgical outcomes over recent years.
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Methorst C, Akakpo W, Graziana JP, Ferretti L, Yiou R, Morel-Journel N, Terrier JE, Beley S, Carnicelli D, Hupertan V, Madec FX, Faix A, Marcelli F, Huyghe E. [Recommendations of the Committee of Andrology and Sexual Medicine of the AFU concerning the management of Varicocele]. Prog Urol 2020; 31:119-130. [PMID: 33308982 DOI: 10.1016/j.purol.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/19/2022]
Abstract
The diagnosis of varicocele is clinical, carried out in supine and standing position and in Valsalva maneuver. Only clinical varicoceles have to be treated. A scrotal ultrasound with Doppler is generally performed as part of the infertile man's evaluation or in case of examination difficulties. The main indication for varicocele treatment is the adult man with clinical varicocele and abnormalities of sperm parameters, in a context of infertility of couple, with a partner having a satisfactory ovarian reserve and no cause of female infertility or a curable infertility cause. The decision to treat varicocele must therefore be taken after evaluation of the two partners of the couple. Adults with symptomatic varicocele and those with spermogram abnormalities may also be offered a cure for their varicocele even in the absence of a paternity plan, as well as adolescents with reduced testicular growth, an ipsilateral decrease testicular volume, or a size gradient between the 2 testes. The cure of varicocele can be carried out by surgery or by percutaneous embolization. Microsurgery (inguinal or subinguinal) offers lower rates of recurrence and complications than high surgical approaches (laparoscopic or not) and surgeries without magnification. It is therefore the reference surgical technique. Percutaneous retrograde embolization is a minimally invasive alternative to microsurgery offering satisfactory outcomes with rare and often benign complications. The cure for varicocele results in an improvement in sperm parameters and recent data seem to confirm that it increases the natural pregnancy rate. These results appear after a delay of 3 to 9 months (at least 1 to 2 cycles of spermatogenesis). When the sperm involvement was severe (azoospermia, severe oligospermia), the improvement of the spermogram allow (1) to avoid surgery testicular sperm extraction or (2) perform intrauterine insemination rather than ICSI.
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Affiliation(s)
- C Methorst
- Service d'urologie, CH des quatre villes, Saint-Cloud, France
| | - W Akakpo
- Service d'urologie, Hôpital universitaire de la Pitié Salpêtrière, Paris, France
| | - J P Graziana
- Clinique mutualiste de la porte de l'Orient, Lorient, France
| | - L Ferretti
- Service d'urologie, Hôpital d'instruction des armées Robert Picqué, Villenave-d'Ornon, France
| | - R Yiou
- Service d'urologie, CHU Henri Mondor, Créteil, France
| | | | - J E Terrier
- Hôpital privé de La Châtaignerie, Beaumont, France
| | - S Beley
- Service d'urologie, Hôpital américain, Paris, France
| | - D Carnicelli
- Service d'urologie, CHU Henri Mondor, Créteil, France
| | - V Hupertan
- Cabinet médical Paris Batignolles, Paris, France
| | - F X Madec
- Service d'urologie, Hôpital Foch, Suresnes, France
| | - A Faix
- 265, avenue des États du Languedoc, Montpellier
| | - F Marcelli
- Service d'urologie, CHRU de Lille, France
| | - E Huyghe
- Département d'urologie, Transplantation Rénale et Andrologie, CHU de Toulouse, site de Rangueil, Toulouse, France.
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Li Z, Hu S, Zhou R, Wang J. Comparison of the efficacy and safety of microscopic and laparoscopic surgery for varicocele. World J Urol 2020; 40:299-300. [PMID: 33169185 DOI: 10.1007/s00345-020-03516-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Zixiang Li
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Simeng Hu
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Raorao Zhou
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Junqi Wang
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu, China.
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Jin L, Yao Q, Wu S, Dai G, Xiang H, Liu X, Xue B. Evaluation of clinical effects of microsurgical subinguinal varicocelectomy with and without testicular delivery. Andrologia 2020; 52:e13605. [PMID: 32339320 DOI: 10.1111/and.13605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to access whether microsurgical subinguinal varicocelectomy (MSV) with testicular delivery has a better therapeutic effect than MSV without testicular delivery, including semen quality, serum testosterone (T) level and International Index of Erectile Function (IIEF)-5 score in infertility male patients with varicocele. In this prospective study, 181 patients were included and they chose the treatment by themselves. A total of 114 patients who received MSV without testicular delivery (TD) and 67 patients who received MSV with TD were followed-up 6 months after the operation. Semen parameters, serum T level and IIEF-5 scores were recorded before and 6 months after the operation. Results showed that MSV with or without TD could improve semen quality, serum T level and IIEF-5 score. For semen quality 6 months after the operation, there was no significant difference between patients received MSV with or without TD. But in patients with varicocele of grade III, MSV without testicular delivery improved the sperm concentration and motility more. And patients received MSV without TD have a higher T level 6 months after the operation, especially in patients ≤27 years. MSV with TD is not superior to that without, but this should be verified in more samples and a better designed randomised controlled study in the future.
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Affiliation(s)
- Lu Jin
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Qiu Yao
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Shujun Wu
- Department of Operating Room, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Guangcheng Dai
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Han Xiang
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Xiaolong Liu
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
| | - Boxin Xue
- Department of Urology, Second Affiliated Hospital of Soochow University, Jiangsu, China.,The Laboratory of Andrology, Second Affiliated Hospital of Soochow University, Jiangsu, China
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Introduction: Surgical treatment of male infertility: a state-of-the-art overview. Fertil Steril 2019; 111:413-414. [PMID: 30722940 DOI: 10.1016/j.fertnstert.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 11/22/2022]
Abstract
Surgical treatments offer effective solutions for many couples experiencing male factor infertility. This Views and Reviews collection of articles offers a state-of-the-art overview of the surgical procedures commonly used to treat impaired male reproductive health.
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