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      Treatment of Bilateral Varicocele and Other Scrotal Comorbidities Using a Single Scrotal Access: Our Experience on 34 Patients

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          Abstract

          Introduction. Varicocele is the main cause of infertility in male and the most correctable cause of it too. In this study, we present our experience on 34 patients affected by bilateral varicocele and other scrotal comorbidities treated underwent surgery with a scrotal access. Materials and Methods. 34 patients were enrolled with clinical palpable and infraclinical (ultrasonic doppler scanning) bilateral varicocele and other comorbidities like right hydrocele, left hydrocele, bilateral hydrocele, and epididymal cyst. They all underwent scrotal bilateral varicocelectomy under local anesthesia. Results and Discussion. At 6 months, no other complications were reported. No case of testicular atrophy was observed. None had recurrence of varicocele. All scrotal comorbidities were treated as well. Conclusion. Scrotal access with local anesthesia is a safe and useful technique to treat patients with bilateral varicocele and other scrotal comorbidities.

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          Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach.

          Ashok Agarwal, Fnu Deepinder, Marcello Cocuzza … (2007)
          To determine the efficacy of varicocelectomy in improving semen parameters. A meta-analysis was performed to evaluate both randomized controlled trials and observational studies using a new scoring system. This scoring system was developed to adjust and quantify for various potential sources of bias, including selection bias, follow-up bias, confounding bias, information or detection bias, and other types of bias, such as misclassification. Of 136 studies identified through the electronic and hand search of references, only 17 studies met our inclusion criteria. The study population was infertile men with clinically palpable unilateral or bilateral varicocele and at least one abnormal semen parameter who had undergone surgical varicocelectomy (high ligation or inguinal microsurgery). Only those studies that had at least three semen analyses (ie, sperm count, motility, and morphology) per patient, before and after surgical varicocelectomy, were included. The combined analysis demonstrated that the sperm concentration increased by 9.71 x 10(6)/mL (95% confidence interval [CI] 7.34 to 12.08, P <0.00001) and motility increased by 9.92% (95% CI 4.90 to 14.95, P = 0.0001) after microsurgical varicocelectomy. Similarly, the sperm concentration increased by 12.03 x 10(6)/mL (95% CI 5.71 to 18.35, P = 0.0002) and motility increased by 11.72% (95% CI 4.33 to 19.12, P = 0.002) after high ligation varicocelectomy. The improvement in World Health Organization sperm morphology was 3.16% (95% CI 0.72 to 5.60, P = 0.01) after both microsurgery and high ligation varicocelectomy. Surgical varicocelectomy significantly improves semen parameters in infertile men with palpable varicocele and abnormal semen parameters.
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            The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. World Health Organization.

            A Aribarg, S Chutivongse, S Koetsawang … (1992)
            To assess the role of varicocele in male infertility. Data analysis of a large population of couples who were systematically investigated for infertility. Couples were recruited in 34 World Health Organization collaborating centers in 24 countries. Nine thousand thirty-four men presenting as partner of infertile couples. None. Physical findings, semen characteristics, coincidental pathology, and spontaneous pregnancies. Varicocele was found in 25.4% of men with abnormal semen, compared with 11.7% of men with normal semen. It was accompanied by decreased testicular volume, impaired sperm quality, and decline of Leydig cell secretion. Spontaneous pregnancies were as frequent in couples in whom the men did or did not have varicocele. Varicocele is clearly associated with impairment of testicular function and infertility.
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              Are varicoceles associated with increased deoxyribonucleic acid fragmentation?

              Armand Zini, Gert R Dohle (2011)
              To perform a literature search on the association between varicocele and sperm DNA fragmentation. Systematic review. Men with a varicocele and infertility. Varicocele repair. Does the presence of a varicocele increase seminal oxidative stress and sperm DNA fragmentation? In men with a varicocele increased levels of reactive oxygen species and sperm DNA damage can be found. This is probably related to defective spermatogenesis in these patients. Seminal oxidative stress is believed to be the source of sperm DNA damage. Patients with a varicocele and oligospermia may also have a diminished seminal antioxidant capacity. After varicocele repair sperm DNA fragmentation decreases. Varicocele is associated with sperm DNA damage, and this sperm pathology may be secondary to varicocele-mediated oxidative stress. The beneficial effect of varicocelectomy on sperm DNA damage further supports the premise that varicocele may impair sperm DNA integrity. Copyright © 2011. Published by Elsevier Inc.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Biomed Res Int
                Journal ID (iso-abbrev): Biomed Res Int
                Journal ID (publisher-id): BMRI
                Title: BioMed Research International
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2314-6133
                ISSN (Electronic): 2314-6141
                Publication date (Print): 2014
                Publication date (Electronic): 23 July 2014
                Volume: 2014
                Electronic Location Identifier: 403603
                Affiliations
                1Department of Urology, Federico II University, Via S. Pansini 5, 80100 Naples, Italy
                2Department of Urology, Hospital Santa Maria delle grazie, Via Domiziana, Località la Schiana, Pozzuoli, 80078 Naples, Italy
                3Department of Urology, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy
                Author notes

                Academic Editor: Ralf Herwig

                Article
                DOI: 10.1155/2014/403603
                PMC ID: 4130299
                SO-VID: 4149301b-953c-40f4-86e7-3e93e1f2acd5
                Copyright © Copyright © 2014 F. Iacono et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 30 April 2014
                Date accepted : 6 June 2014
                Categories
                Subject: Clinical Study

                Data availability:

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