Varicocele Embolization: Patient Selection: Preprocedure Workup, and Technical Considerations

AbstractVaricocele refers to an abnormally dilated and tortuous pampiniform venous plexus within the spermatic cord. The prevalence of varicocele is reported to be approximately 15% in the general male population. Its incidence increases with age and has a higher incidence in infertile men. Varicocele treatment (surgical or interventional) is considered one of the most common therapies of reversible infertility in men. Percutaneous embolization offers nonsurgical, minimally invasive option for the treatment of varicoceles, requiring only minimal sedation. In this article, the authors review the clinical and technical details of percutaneous varicocele embolization with a summary of currently available evidence.

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Obstructions

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.9098 ◽

2011 ◽

pp. 1428-1429

Author(s):

Franco Dondero ◽

Francesco Lombardo

Keyword(s):

Recent Progress ◽

Diagnosis And Treatment ◽

Obstructive Azoospermia ◽

Male Population ◽

Infertile Men ◽

General Male Population ◽

Normal Spermatogenesis ◽

Clinical Conditions ◽

Secretory Azoospermia

Azoospermia, the absence of sperm, is the most challenging of clinical conditions despite recent progress in diagnosis and treatment. The prevalence of azoospermia is less than 1% among all men, and approximately 10–15% among infertile men. Its incidence in the general male population is 2–3% (1). Testicular (secretory) azoospermia is untreatable in most cases, and even when a cure can be attempted, success is usually low. Obstructive azoospermia, in contrast, is characterized by normal spermatogenesis and is therefore potentially treatable. Accordingly, this condition has always been the focus of physicians’ interest and attention.

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Two Case Reports of Varicocele Rupture during Sexual Intercourse and Review of the Literature

Case Reports in Urology ◽

10.1155/2018/4068174 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Chalil Arif ◽

Konstantinos Kotoulas ◽

Chrysostomos Georgellis ◽

Konstantinos Frigkas ◽

Athanasios Bantis ◽

...

Keyword(s):

Sexual Intercourse ◽

Spermatic Cord ◽

Case Reports ◽

Rare Complication ◽

Traumatic Rupture ◽

Male Population ◽

First Case ◽

Key Points ◽

General Male Population ◽

Scrotal Hematoma

Varicocele is characterized by the dilatation of the veins of the spermatic cord. Its prevalence in general male population is 15% while in the infertile population the prevalence rises up to 25%. The varicocele is considered an etiological factor for male infertility. Although different pathophysiological patterns have been proposed, there is no consensus in the urological society to date. In most of the cases varicocele is asymptomatic but sometimes gives mild symptoms as dull pain at the scrotal region. A rare complication of this condition is the spontaneous or traumatic rupture and hematoma formation, either as spermatic cord hematoma or as scrotal hematoma. We are presenting two cases of varicocele rupture, presented with acute painful swelling of the left inguinal and scrotal region during sexual intercourse. Imaging studies revealed a scrotal hematoma in the first case and a spermatic cord hematoma in the second case, without signs of active bleeding. Both patients were treated conservatively and recovered uneventfully. Subsequently, we reviewed the literature in an effort to find the key points for the diagnosis and treatment of this condition.

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Cryptorchidism and Fertility

Clinical Medicine Insights Reproductive Health ◽

10.4137/cmrh.s25056 ◽

2015 ◽

Vol 9 ◽

pp. CMRH.S25056 ◽

Cited By ~ 20

Author(s):

Fatma Fawzy ◽

Amr Hussein ◽

Mostafa Mahmoud Eid ◽

Ahmed Mahmoud El Kashash ◽

Hosni Khairy Salem

Keyword(s):

Normal Development ◽

Antisperm Antibodies ◽

Male Population ◽

Infertile Men ◽

General Male Population ◽

History Of

Cryptorchidism, the failure of one or both testes to descend into the scrotum prenatally, occurs in 2.4%-5% of newborns. Many of these testes will descend spontaneously shortly after birth, but ~23% will remain undescended unless surgery is performed. Bilaterally cryptorchid men have a six times greater risk of being infertile when compared with unilaterally cryptorchid men and the general male population. Approximately 10% of infertile men have a history of cryptorchidism and orchidopexy. The main reasons for infertility in men with a history of cryptorchidism treated by orchidopexy are maldevelopment of the testes and an improper environment for the normal development of the testes, hyperthermia, and antisperm antibodies.

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Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.2013209 ◽

2013 ◽

Vol 16 (5) ◽

pp. E295-E297 ◽

Cited By ~ 3

Author(s):

Joseph Lamelas ◽

Christos Mihos ◽

Orlando Santana

Keyword(s):

Mitral Regurgitation ◽

Minimally Invasive ◽

Median Sternotomy ◽

Rational Approach ◽

Functional Mitral Regurgitation ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Mitral Annuloplasty ◽

Technical Details ◽

Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

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Transcatheter Closure of PFO and ASD: Multimodality Imaging for Patient Selection and Perioperative Guidance

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8070078 ◽

2021 ◽

Vol 8 (7) ◽

pp. 78

Author(s):

Gabriele Egidy Assenza ◽

Luca Spinardi ◽

Elisabetta Mariucci ◽

Anna Balducci ◽

Luca Ragni ◽

...

Keyword(s):

Patient Selection ◽

Transcatheter Closure ◽

Multimodality Imaging ◽

Deep Understanding ◽

Volume Overload ◽

Arterial Embolization ◽

Ventricular Volume ◽

Intracardiac Echocardiography ◽

Technical Details ◽

Asd Closure

Transcatheter closure of patent foramen ovale (PFO) and secundum type atrial septal defect (ASD) are common transcatheter procedures. Although they share many technical details, these procedures are targeting two different clinical indications. PFO closure is usually considered to prevent recurrent embolic stroke/systemic arterial embolization, ASD closure is indicated in patients with large left-to-right shunt, right ventricular volume overload, and normal pulmonary vascular resistance. Multimodality imaging plays a key role for patient selection, periprocedural monitoring, and follow-up surveillance. In addition to routine cardiovascular examinations, advanced neuroimaging studies, transcranial-Doppler, and interventional transesophageal echocardiography/intracardiac echocardiography are now increasingly used to deliver safely and effectively such procedures. Long-standing collaboration between interventional cardiologist, neuroradiologist, and cardiac imager is essential and it requires a standardized approach to image acquisition and interpretation. Periprocedural monitoring should be performed by experienced operators with deep understanding of technical details of transcatheter intervention. This review summarizes the specific role of different imaging modalities for PFO and ASD transcatheter closure, describing important pre-procedural and intra-procedural details and providing examples of procedural pitfall and complications.

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Effect of Intermittent Hypoxia on Metabolic Syndrome and Insulin Resistance in the General Male Population

Medicina ◽

10.3390/medicina57070668 ◽

2021 ◽

Vol 57 (7) ◽

pp. 668

Author(s):

Jung-Yup Lee ◽

Chan-Won Kim ◽

Kyung-Chul Lee ◽

Jae-Hyuk Lee ◽

Sung-Hun Kang ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Density Lipoprotein ◽

Resistance Index ◽

Health Examination ◽

Male Population ◽

Incident Type ◽

Obstructive Sleep ◽

General Male Population ◽

Group 5

Background and objectives: Obstructive sleep apnea (OSA) is closely associated with insulin resistance (IR) and is an independent risk factor for incident type 2 diabetes mellitus (T2DM). Most studies evaluate the correlation between OSA and IR in only obese or T2DM patients. Therefore, we tried to investigate the effect of OSA on metabolic syndrome and IR in the general healthy male population. Materials and Methods: 184 subjects who visited a preventive health examination program were recruited for this study. All subjects received overnight polysomnography by a portable device (Watch-PAT 200). We examined several metabolic parameters and a homeostasis model of assessment for insulin resistance index (HOMA-IR). The subjects were divided into three groups by AHI (Apnea-hyponea index): normal group (AHI < 5), mild OSA group (5 ≤ AHI < 15), and moderate-severe OSA group (AHI ≥ 15). They were also divided into two groups according to minimum oxygen saturation: low group, Min-SpO2 < 88%; and high group, Min-SpO2 ≥ 88%. Results: Parameters of metabolic syndrome, including waist circumference, systolic and diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol showed significant differences among the AHI groups. Furthermore, HOMA-IR showed significant differences among the AHI groups. Those parameters, including metabolic syndrome and HOMA-IR, also showed differences between Min-SpO2 groups. Conclusions: In summary, this study helps confirm that AHI is associated with HOMA-IR in the general male population. Furthermore, the severity of AHI correlated with the parameters of metabolic syndrome. Therefore, AHI might be an indicator for evaluating both T2DM and metabolic syndrome, even in the general male population.

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Prediction of coronary heart disease incidence in a general male population by circulating non-coding small RNA sRNY1-5p in a nested case–control study

Scientific Reports ◽

10.1038/s41598-021-81221-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Vera L. Costa ◽

Jean-Bernard Ruidavets ◽

Vanina Bongard ◽

Bertrand Perret ◽

Emanuela Repetto ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Small Rna ◽

Case Control Study ◽

Disease Incidence ◽

Case Control ◽

Male Population ◽

General Male Population ◽

Nested Case Control ◽

Control Study

AbstractDuring the development of atherosclerotic lesion, s-RNYs (small RNAs of about 24/34 nucleotides) are derived by the processing of long Ro-associated non-coding RNAs (RNYs) in macrophages. The levels of serum s-RNYs have been found significantly upregulated in patients with coronary heart disease (CHD) compared to age-matched CHD-free individuals. The present study aimed to examine the predictive value of serum s-RNYs for CHD events in the general male population. Within the frame of nested-case–control study, the GENES study, we measured the absolute expression of a RNY-derived small RNA, the s-RNY1-5p, in the serum of individuals (without CHD at baseline) who encountered a CHD event within 12 years of follow-up (n = 30) (Cases) and compared them to individuals who remained event-free (Controls) (n = 30). The expression of s-RNY1-5p in serum was significantly upregulated in Cases compared to Controls (p = 0.027). The proportion of CHD event-free was significantly higher among individuals with serum s-RNY1-5p below the median value (631 molecules/mL). In a multivariable model adjusted for age, smoking, hypertension, diabetes and dyslipidemia, the risk of CHD events increased more than fourfold in individuals with serum s-RNY1-5p above the median value (HR, 4.36; 95% CI 1.22–15.60). A positive association with CHD events was also observed when considering s-RNY1-5p as a continuous variable (p = 0.022). Based on our results, we conclude that serum s-RNY1-5p is an independent predictor of CHD events in a general male population and might be a relevant biomarker for early detection of cardiovascular diseases.

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