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 ◽  
...  

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.

Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo

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.


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Mustafa Gökhan Köse ◽  
Kadir Önem ◽  
Mehmet Çetinkaya ◽  
Erkan Karadağ ◽  
Emre Arpali

Objective. To investigate the question of whether duration of pain before surgery ultimately affects sperm parameters after varicocelectomy.Methods. Fifty patients with painful grade-3 varicocele were investigated prospectively. The patients were divided into two groups according to their symptom period. The patients having had grade-3 varicocele for less than 1 year were included in Group-1 (Ge,n=25). Twenty-five patients who had painful grade-3 varicocele for more than 1 year (Gs,n=25) were classified in Group-2. Semen analysis was performed after 3 days of sexual abstinence twice a month. Total sperm concentration (TSC), rapidly progressive motility (SPa), and slow or sluggish motility (SPb) rates were noted. Pain was evaluated by using 10 cm visual analogue scale (VAS).Results. Postoperative TSC and %SPb were significantly higher in both groups (P=0.01). There was no difference between two groups for preoperative and postoperative TSC, %SPa, % and SPb values. VAS significantly declined in both groups (P=0.005). This postoperative decline was not significant for intergroup comparison.Conclusions. Our results show that increase in semen quality and decrease in the pain after microsurgery varicocelectomy do not depend on the duration of the preoperative pain.


Author(s):  
Suraj Mathur ◽  
P. Rajan ◽  
Dr. Jaya Kumar E. K

Method: A sample size of 40 kidney allograft recipients undergoing color Doppler Ultrasonography evaluation included in the study. Result: Corticomeduallry differentiation of kidney allografts within 24 hours post transplant period: There was no significant difference between CMD of kidney allorgrafts with complication and kidney allografts without any complication within 24 hour because the standard deviations of both groups were 0. Corticomeduallry differentiation in all kidney allografts, all were shows maintained corticomedullary differentiation. Conclusion: This study is aimed to assessing the role of CDUS in kidney allograft recipients to evaluate the graft perfusion immediate after anastamosis, within 24 hours and follow up period after engraftment of kidney allograft. Analyse the Color Doppler Ultrasound (CDUS) indices changes in parenchymal, and vascular cause of allograft dysfunction at follow up periods, to evaluate the uroloical, surgical and vascular complications in kidney recipients by using gray scale and color Doppler US at follow up periods and compare the results with biochemical parameter (serum creatinine). Immediate Doppler ultrasound is highly useful in the diagnosis of primary graft dysfunction and in follow-up of the transplanted patient. Keywords: Graft Perfusion, Anastamosis, Color, Doppler, Ultrasound


Author(s):  
Sneha S. ◽  
Sreelatha S. ◽  
Renuka Ramaiah

Background: The current study follows grannum grading of placenta. It is well known that there is accelerated placental maturation in PIH patients and the ultrasonic appearance of grade 3 placenta before 37 weeks may signify placental dysfunction and is associated with development of low birth weight babies, IUGR meconium stained liquor, low APGAR score. Hence this study was conducted to emphasize on placental grading at different periods of gestation to predict and prevent increased obstetric and fetal compromise and to compare the outcomes.Methods: Obstetric scans were performed in all PIH patients attending antenatal OPD and inpatients at ESIC and PGIMSR medical college, Bangalore to know the placental grading and biophysical profile. These women were followed till their delivery for obstetric and fetal outcomes.Results: Grade 3 placenta is seen in 17 patients in group 1(50%) and 39 patients (59%) in group 2. For statistical analysis grade 1 and 2 were combined and compared with  grade 3. P-value 0.198 which was not statistically significant. There was no statistically significant difference in age and gravidity between two groups. The medical disorders were more in group 2 i.e., between 37 - 40 weeks. The complications of PIH were also more in group 2. There were more number of LSCS (n=19 versus 14) in 34-36 weeks group which was not statistically significant. Fetal outcomes like IUGR and IUD were more in group 2 which was not statistically significant. The mean birth weight in group 1 was 2 kg as compared to 2.7 kg in group 2. All associated medical disorders were more in group 2.Conclusions: In hypertensive women there is accelerated placental maturation leading to maternal and fetal complications. Hence women with accelerated placental maturity in ultrasound should be closely monitored and appropriately managed. However, we recommend larger randomized studies are necessary.


2017 ◽  
Vol 89 (3) ◽  
pp. 219 ◽  
Author(s):  
Mehmet Zeynel Keskin ◽  
Salih Budak ◽  
Evrim Emre Aksoy ◽  
Cem Yücel ◽  
Serkan Karamazak ◽  
...  

Aim: To evaluate the effects of body mass index (BMI) ratio on semen parameters and serum reproductive hormones. Materials and methods: The data of 454 patients who prsented to male infertility clinics in our hospital between 2014 and 2015 were analyzed retrospectively. Weight, height, serum hormone levels and semen analysis results of the patients were obtained. BMI values were calculated by using the weight and height values of the patients and they were classified as group 1 for BMI values ≤ 25 kg/m2, as group 2 for BMI values 25-30 kg/m2 and as group 3 for BMI values ≥ 30 kg/m2. Results: The mean values of BMI, semen volume, concentration, total motility, progressive motility, total progressive motile sperm count (TPMSC), normal morphology according to Kruger, head abnormality, neck abnormality, tail abnormality, FSH, LH, prolactin, T/E2, total testosterone and estradiol parameters of the patients were considered. Patients were divided according to BMI values in Group 1 (n = 165), Group 2 (n = 222) and Group 3 (n = 56). There was no statistically significant difference in terms of all variables between the groups. Conclusions: We analyzed the relationship between BMI level and semen parameters and reproductive hormones, demonstrating no relationship between BMI and semen parameters. In our study, BMI does not affect semen parameters although it shows negative correlation with prolactin and testosterone levels.


2016 ◽  
Vol 27 (2) ◽  
pp. 135-140 ◽  
Author(s):  
José B. Barbosa ◽  
Charles Costa De Farias ◽  
Flávio E. Hirai ◽  
José Á. Pereira Gomes

Purpose To compare amniotic membrane transplantation (AMT) associated with narrow-strip conjunctival autograft vs conjunctival autograft alone for the treatment of recurrent pterygium. Methods In this prospective consecutive interventional study, patients with recurrent pterygium were randomly divided into one of 2 groups; group 1: patients undergoing AMT associated with autologous conjunctival graft; and group 2: patients undergoing conjunctival autograft alone. Results Of the 80 operated eyes included in this study, 39 (group 1, mean patient age 52.1 ± 11.7 SD years) underwent AMT associated with narrow-strip conjunctival autograft and 41 (group 2, mean patient age 45.8 ± 12.9 SD years) underwent conjunctival autograft alone. In group 1, 6 eyes (15.4%) had grade 1 pterygium, 19 eyes (48.7%) had grade 2 pterygium, and 14 eyes (35.9%) had grade 3 pterygium. In the second group, 5 eyes (12.2%) had grade 1 pterygium, 18 eyes (43.9%) had grade 2 pterygium, and 14 eyes (35.9%) had grade 3 pterygium. No statistically significant difference was found between the 2 groups (p = 0.752). Of the 39 eyes in group 1, recurrent pterygium was observed in 7 cases (17.9%). However, of the 41 eyes in group 2, recurrent pterygium was observed in only 4 cases (9.75%). No statistically significant difference was found between the 2 groups (p = 0.2684). Conclusions The results of this study indicate that conjunctival autograft alone might be a better surgical choice for the treatment of recurrent pterygia than combining it with AMT; however, this second option provides a good surgical alternative in cases where little conjunctival donor tissue is available.


2020 ◽  
Vol 11 (2) ◽  
pp. 81-92
Author(s):  
Iana Campinho Braga de Araújo Lima ◽  
´´Italo Medeiros Azevedo ◽  
Keyla Borges Ferreira Rocha ◽  
Aldo Cunha Medeiros

Objective: This study aimed at examining whether topical treatment of colon anastomosis with hyaluronic acid can influence the healing of colonic anastomosis in rats treated with systemic corticosteroid. Methods: Three groups of Wistar rats weighing 252 ± 7g were used, with six rats each, all submitted to anastomosis of the proximal colon: Group 1 - control rats, without treatment. Group 2 - rats treated with subcutaneous (s.c) corticosteroid, and topical application of 0.9% saline solution over the anastomosis. Group 3 - rats treated with corticosteroid s.c. and topical application of 0.4% hyaluronic acid (10 mg/ml) on colonic anastomosis. On the 7th postoperative day, under anesthesia and laparotomy, the anastomosis site was subjected to the determination of rupture pressure. Then, samples containing the anastomosis site were resected and fixed in 10% buffered formaldehyde and embedded in paraffin. Masson H-E and trichrome staining. Histometry evaluated the infiltration of inflammatory cells at the anastomosis site, using a numerical scale from 0 to 4. Continuous variables were assessed using the Tukey test. Differences considered significant with p<0.05. Results: All animals survived the experiments. There were no abscesses, fistulas and macroscopically detectable dehiscences in the anastomosis site. The weight of the animals on the 7th postoperative day showed a statistically significant difference (p<0.001) between the control (253.6±6.3g) and corticoid (221.6±15.4g) groups, as well as between the corticoid +. hyaluronic acid group (257.8±9.7g) and corticosteroids (221.6±15.4). There was no significant difference in the comparison between the control and corticoid + hyaluronic acid groups (p>0.05). In the analysis of intraluminal pressure of colonic anastomosis, there was a statistically significant difference when comparing groups 1 (286.8±9.9 mmHg) and 2 (155±6.0 mmHg), 1 (286.8±9,9 mmHg) and 3 (199.1±7.7) and 2 (155±6.0 mmHg) and 3 (199.1±7.7), with p<0.001 for all comparisons. Histopathological classification by the numerical scale: Group 1 - inflammatory response (H-E) grade 3 and collagen deposition by Masson Trichomic grade 1; Group 2 - inflammatory response (H-E) grade 4 and deposition of collagen and fibroblasts by Masson's Trichrome grade1\2; Group 3 - inflammatory response (H-E) grade 3 and deposition of collagen and fibroblasts by Masson's Trichrome grade 1\2. There was no significant difference between groups. Conclusion: The topical use of hyaluronic acid has a positive influence on the initial healing phase of colonic anastomosis in rats treated with systemic corticosteroid.


2021 ◽  
Vol 8 (2) ◽  
pp. 606
Author(s):  
Haydar Celasin ◽  
Faraj Afandiyev

Background: We aimed to determine the incidence and predictors of testicular atrophy (TA) in patients undergoing inguinal hernia repair at our hospital.Methods: The total patient number is 578.The patients were divided Group-1 (developed testicular atrophy) and Group-2 (did not develop testicular atrophy). The testicles were evaluated with Scrotal Color Doppler Ultrasonography (SCDU) in preoperative and postoperative third month.Results: Median age in the Group - 1 and Group - 2 respectively is 64,0±12,3 (47-81) and 48,9±17,4 (18-89) (p=0.037). TA developed in 5.01% (29/578) of the patients. We determined that TA developed more often in the patients who are over the age of 40 (p=0.007), in secondary cases (p<0.001), in  open repair (p<0.001), those who do not use perioperative narcotic and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (p<0.001), those who use perioperative antispasmodic drugs (p=0.017), those having a rheumatic disease(RD) and  diabetes mellitus(DM) (p<0.001).Results of multivariate analysis, testicular atrophy development increases when perioperative NSAID is not used ( OR:13.24; 95% CI:4.19-41.87; p<0.001) , perioperative narcotic is not applied (OR:13.91; 95% CI:4.35-44.55; p<0.001) and RD exists (OR:0.10; 95%CI:0.03-0.35; p<0.001).Conclusions: Advanced age, DM and rheumatic disease, not using perioperative NSAIDs, narcotic drugs and antispasmodic drugs increases the risk of testicular atrophy.


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