Outcome of Extended Varicocelectomy in Case of High Grade Varicocele

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Essamt ◽  
Ahmed Mohamed Tawfeek ◽  
Osama Mostafa Tawfeek Abo Faddan
Keyword(s):  
Beneficial Effect ◽  
Surgical Approach ◽  
Spermatic Cord ◽  
Doppler Ultrasonography ◽  
Semen Analysis ◽  
Semen Parameters ◽  
High Grade ◽  
Postoperative Evaluation ◽  
Evaluation Period ◽  
Pampiniform Plexus

Abstract Background Varicocele is defined as abnormal dilation and tourtousity of the internal spermatic veins within the pampiniform plexus. It is common among adolescents and may contribute significantly to the risk of subfertility in adulthood. Objective To evaluate the outcome of extended varicocelectomy in case of high grade varicocele. Patients and methods In all, 30 varicocele cases including 12 left sided and 18 bilateral, comprising 48 spermatic cord units with clinically palpable varicocele and affected semen analysis underwent extended varicocele ligation. Testicular delivery was done in all the cases and assessment of the gubernacular veins was reported. The patients underwent clinical evaluation, scrotal doppler ultrasonography, as well as semen analysis to detect varicocele recurrence, hydrocele formation and early changes in semen parameters. The postoperative evaluation period was 3 months. Results No varicocele recurrences were clinically detectable after our surgical approach, No hydrocele formation, and There was improvement in the parameters of semen analysis in the entire patients presented with infertility associated with varicocele as regard improvement in the count, motility, and decrease in the abnormal forms 3 months after varicocelectomy. Conclusion Extended varicocele ligation with delivery of the testis achieve good surgical outcome with minimal varicocele recurrence and hydrocele formation, and offer beneficial effect on semen parameters.

scholarly journals Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters

2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  
Keyword(s):  
Physical Examination ◽  
Doppler Ultrasonography ◽  
Semen Analysis ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
Semen Parameters ◽  
Significant Difference ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

Racial and Sociodemographic Differences of Semen Parameters Among US Men Undergoing a Semen Analysis

Urology ◽  
2019 ◽  
Vol 123 ◽  
pp. 126-132 ◽  
Author(s):  
Clara Helene Glazer ◽  
Shufeng Li ◽  
Chiyuan Amy Zhang ◽  
Aleksander Giwercman ◽  
Jens Peter Bonde ◽  
...  
Keyword(s):  
Semen Analysis ◽  
Semen Parameters ◽  
Sociodemographic Differences

scholarly journals SEMEN pH;

2012 ◽  
Vol 19 (02) ◽  
pp. 234-241
Author(s):  
HENRY. A. MWAKYOMA ◽  
ERICK. P. MAGOROSA
Keyword(s):  
Hormonal Regulation ◽  
Seminal Fluid ◽  
Sperm Count ◽  
Semen Analysis ◽  
Staining Technique ◽  
Semen Parameters ◽  
Morphological Examination ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
The World

Background: Male infertility is a frequent reproductive health problem in the world. It is usually related to abnormal spermproduction or function and these abnormalities can occur anywhere in the production of sperm including hormonal regulation, storage andtransport of sperm. Various factors are known to be responsible for seminal fluid abnormalities. Usually the first step in evaluating for maleinfertility is semen analysis. Setting: The study was conducted at Muhimbili National Hospital mainly in the department of Pathology laboratory,cytology unit. Study design: The study was a hospital based cross-sectional type. Objective: To determine semen pH in patients presenting withinfertility complains and relate how pH of seminal fluid and other semen parameters influence each other. Material and methods: Beforesemen collection, patients were instructed to abstain from sexual intercourse for a minimum of 48 hours to 7 days and collect semen bymasturbation and transport it to the laboratory through shirt pocket. Semen was to reach the laboratory for examination in not more than onehour from time of collection. Semen was examined macroscopically for volume, colour, viscosity and pH by using a pH meter (Consort C830)followed by microscopic examination which included motility of spermatozoa and sperm count by using Neuber counting chamber. The smearwas made on glass slides, fixed in 95% ethyl alcohol for 30 minutes then stained by using Papanicolaou’s staining technique and then analyzedmicroscopically for morphological examination. Results: In the analysis of the influence of semen parameters on semen pH, there wasdecrease in seminal fluid pH with age whereby as age increased the pH of seminal fluid decreased.. The general trend observed was that thepH of seminal fluid tended to decrease with an increase in the days of abstinence. pH tended to decrease with an increase of seminal fluidvolume. The pH of seminal fluid also increased with an increase in viscosity (Hyperviscosity >Hypoviscosity). The pH of seminal fluid in patientswith less than 50% forward progressive movement of spermatozoa was higher when compared to those with more than 50% forwardprogressive movement. pH had an influence on the motility of spermatozoa. Conclusions and recommendation: pH and other parameterstended to have an influence each other during seminal analysis in our study. There is a variation of pH in different parts of the World according tothe studies done. It is recommended that pH should be included during seminal analysis because our study has shown that it affects most of theseminal fluid parameters in and contribute to the problem of infertility.

scholarly journals Oral Antioxidants Mitigate Levels of Malonedialdehyde and Protein Carbonyl and Improve Semen Parameters in Men with Oligoasthenozoospermia

2020 ◽  
Author(s):  
Vegim Zhaku ◽  
Sheqibe Beadini ◽  
Nexhbedin Beadini ◽  
Gazmend Amzai
Keyword(s):  
Oxidative Stress ◽  
Standard Deviation ◽  
Side Effects ◽  
Semen Analysis ◽  
Pearson Correlation ◽  
Protein Carbonyl ◽  
Semen Parameters ◽  
Duration Of Treatment ◽  
Treatment Regimens ◽  
Raising Awareness

Abstract Raising awareness about treating options in North Macedonia, while sperm parameters are decreasing because of increased oxidative stress, in a terrain like this, represents a big challenge. All the patients that fulfilled the required criteria, 37 were enrolled in the study signing a document that explains nature of the study. The first semen sample was collected with at least three days of abstinence. From the sample 0.5 ml was used for standard semen analysis, 1.2 ml was used to evaluate the levels of malonedialdehyde (MDA) and protein carbonyl (PC). The last sample was collected after 6 months. Mean, Standard Deviation, the Pearson Correlation and an independent student t-test were used for statistical analyses. Concentration and motility were significantly increased after 6 months of treatment (p<0.001).The level of MDA shows significantly lower values after six months of therapy with antioxidants (p<0.001).Whereas another marker which is denoted by PC was also lower after the treatment, but was not statistically significant (p=0.0554). There is, however, lack of agreement, because improvement is not consistent and there is wide variation in the treatment regimens, on the dose and duration of treatment and whether mono or combined oral antioxidants should be administered. Always keep on mind that, antioxidants are not free from potential side effects “antioxidant paradox”.

scholarly journals P–070 Evaluation of SARS-CoV–2 in human semen and effect on total sperm number: A prospective observational study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Best ◽  
M Kuchakulla ◽  
K Khodamoradi ◽  
T Lima ◽  
F Frech ◽  
...  
Keyword(s):  
Semen Analysis ◽  
Epidemiological Data ◽  
Semen Parameters ◽  
Human Semen ◽  
Sperm Number ◽  
Rt Pcr ◽  
Sperm Analysis ◽  
Reproductive Techniques ◽  
The Impact

Abstract Study question Is the SARS-CoV–2 virus present in human semen and what is the impact on semen parameters following an infection? Summary answer SARS-CoV–2 infection, though not detected in semen of recovered men, can affect TSN in ejaculate in the acute setting. What is known already Early epidemiological data has suggested that the primary mode of transmission is through respiratory droplets, but the presence of SARS-CoV–2 has been identified in other bodily fluids such as feces, urine, and semen. Study design, size, duration We prospectively recruited thirty men diagnosed with acute SARS-CoV–2 infection using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) of pharyngeal swab specimens. Thirty semen samples from recovered men were obtained 11–64 days after testing positive for SAR-CoV–2 infection. The median duration between positive SAR-CoV–2 test and semen collection was 37 days (IQR=23). Participants/materials, setting, methods Semen samples were collected from each individual using mailed kits. Follow-up semen samples were done with mailed kits or in-person in office setting. Semen analysis and PCR was performed after samples were received. Main results and the role of chance The median total sperm number (TSN) in ejaculate was 12.5 million (IQR=53.1). When compared with age-matched SARS-CoV–2(-) men, TSN was lower among SARS-CoV–2(+) men (p = 0.0024). Five men completed a follow-up sperm analysis (median 3 months) and had a median TSN of 18 million (IQR=21.6). No RNA was detected by means of RT-PCR in the semen in 16 samples tested. Limitations, reasons for caution First, most of the semen samples came from non-severe men of whom were in the recovery stage and lacked symptoms. Additionally, our sample size was relatively small and overnight mail-in semen analysis kits were used during the acute phase of infection to minimize contact with positive subjects. Wider implications of the findings: Our findings suggest extremely low risk of viral transmission during sexual contact and assisted reproductive techniques, although further data need to be obtained. The impact on TSC in recovered men from SARS-CoV–2 infection is concerning, nevertheless long-term follow-up of these men is critical to determine the nadir of TSC. Trial registration number 20200401

scholarly journals Male Fertility and Reduction in Semen Parameters: A Single Tertiary-Care Center Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
D. Milardi ◽  
G. Grande ◽  
D. Sacchini ◽  
A. L. Astorri ◽  
G. Pompa ◽  
...  
Keyword(s):  
Reference Values ◽  
Male Fertility ◽  
Ethical Issues ◽  
Semen Analysis ◽  
Care Center ◽  
Tertiary Care ◽  
Healthcare Services ◽  
University Hospital ◽  
Semen Parameters ◽  
Spontaneous Conception

Background. Infertility is both a clinical and a public problem, affecting the life of the couple, the healthcare services, and social environment. Standard semen analysis is the surrogate measure of male fertility in clinical practice.Objective. To provide information about the relationship between semen parameters and spontaneous conception.Methods. We evaluated retrospectively 453 pregnancies that occurred among 2935 infertile couples evaluated at an infertility clinic of a tertiary-care university hospital, between 2004 and 2009.Results. Normal semen analysis was present only in 158 patients; 295 subfertile patients showed alterations in at least one seminal parameter. A reduction in all seminal parameters was observed in 41 patients. Etiological causes of male infertility were identified in 314 patients.Conclusion. Our data highlights the possibility of a spontaneous conception with semen parameters below WHO reference values. Therefore, we support the importance of defining reference values on a population of fertile men. Finally, we analyzed the related ethical issues.

P–100 Metabolic, hormonal, and inflammatory status in sub-fertile men with obesity and diabetes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Abbasihormozi ◽  
A Kouhkan ◽  
A Shahverdi ◽  
A Parhizkar ◽  
Z Zolfaghary ◽  
...  
Keyword(s):  
Semen Analysis ◽  
Metabolic Changes ◽  
Semen Parameters ◽  
Computer Assisted ◽  
Obesity And Diabetes ◽  
Hormonal Dysfunction ◽  
Hs Crp ◽  
Type 2 Diabetic

Abstract Study question To evaluate the association between sperm functionality parameters and biochemical, hormonal, and inflammatory indices in obese and diabetic men. Summary answer Metabolic changes,hormonal dysfunction,and the presence of inflammatory mediators might be considered possible mechanisms in the development of sub-fertility in obese and diabetic sub-fertile men What is known already Although the higher prevalence of subfertility in obese and diabetic men during the reproductive age is evident, the mechanisms by which obesity and diabetes mellitus (DM) cause male infertility are not entirely understood. Several pathways might be involved in the role of obesity in semen quality, thereby inducing alterations in hormonal profiles, abnormal lipid metabolism, and possibly the formation of inflammatory cytokines, ultimately leading to impaired sperm function Study design, size, duration We enrolled normal weight (BMI&lt;25 kg/m2) and non-type–2 diabetic (control=40), obese and non- type–2 diabetic (obese=40), non-obese and type–2 diabetic (Lean-DM=35), and obese and type–2 diabetic (Obese-DM=35) sub-fertile men, aged 20–50 years, referring to Royan infertility clinic (Tehran, Iran) from March to September 2014 Participants/materials, setting, methods After enrollment and receiving informed consent, all men underwent face-to-face private interviews. The obesity-associated markers, insulin resistance, beta-cell function, hormonal and lipid profile, inflammatory indices, and semen analysis were assessed in four experimental groups. Semen analysis was examined after 2–5 days of sexual analysis).abstinence based on WHO-recommended methods by CASA system (computer-assisted sperm Main results and the role of chance Main results and the role of chance: Our finding showed that diabetic markers were significantly increased in two diabetic groups, while obesity indices were markedly increased in two obese groups. Conventional sperm parameters were significantly lower in obese DM, lean DM, and obese groups compared with the control (p &lt; 0.05). Serum levels of total testosterone (TT) and sex hormone-binding globulin (SHBG) were significantly lower in men with obesity and DM compared with the control (p &lt; 0.05).There was a significant difference in the concentration of high-sensitivity C-reactive protein (hs-CRP) among four experimental groups. Moreover, serum leptin was significantly increased in obese DM, lean DM, and obese groups. Serum insulin levels had a positive correlation with metabolic-associated indices (WC, BMI, FBS,HbA1c,and HOMA-IR), as well as hs-CRP levels, whereas it had a negative correlation with count, motility, and morphology. There is also a negative association between metabolic-associated indices (WC, BMI, FBS, HbA1c, and HOMA-IR) and semen parameters. Limitations, reasons for caution It was better to evaluate inflammatory biomarkers be examined in other tissues Wider implications of the findings: The results of this study demonstrated the association of metabolic changes, hormonal dysfunction, and inflammatory responses with the semen parameters of sub-fertile men with obesity and diabete. Trial registration number Not applicable

Estimation of haemodynamic changes in varicocele testis and results after microsurgical sub-inguinal varicocelectomy

2021 ◽  
pp. 039156032110690
Author(s):  
Satyadeo Sharma ◽  
Rajendra K Shimpi
Keyword(s):  
Semen Analysis ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Semen Parameters ◽  
Medical Institute ◽  
Sperm Density ◽  
Doppler Study ◽  
Diastolic Velocity ◽  
Before And After ◽  
Haemodynamic Changes

Introduction: Varicocele is among the most frequently encountered, surgically correctable causes of male infertility. Since varicocele is a primary abnormality of testicular vessels, a thorough understanding of haemodynamic changes in the microcirculation of varicocele testis is needed. Objectives: To estimate changes in the microcirculation of varicocele testis and correlate them with symptomatic and semen parameters changes before and after varicocelectomy. Material and methods: This prospective, observational study includes 47 patients of age group 18–40 years who underwent microsurgical varicocelectomy during June 2016 to April 2018 at a tertiary medical institute. Testicular haemodynamic was evaluated using a colour spectral doppler study (PSV-Peak systolic velocity/ESV-End diastolic velocity/RI-Resistive index/PI-Pulsatility index). Semen analysis parameters and testicular blood flow were compared with pre-operative values. Results: RI in the capsular artery of varicocele affected testis, which was 0.61 ± 0.11 (mean ± SD), significantly reduced to 0.56 ± 0.09 (mean ± SD) in post-operative follow-up, indicating improved perfusion. Pre-operative sperm density was noted to be 15.94 ± 7.88 (mean ± SD), which improved to 28.41 ± 10.99, Progressive sperm motility from 33.81 ± 10.88 to 38.32 ± 9.21 and morphology from 36.13 ± 10.68 to 41.43 ± 9.29 on 6-month follow-ups ( p < 0.05). Conclusion: Varicocele testis is associated with altered testicular haemodynamic, which insults spermatogenesis. Microsurgical varicocelectomy with testicular artery and lymphatic preservation leads to correction of this altered haemodynamic state and improves the testicular microcirculation.

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