Correlation between Testicular Hemodynamic and Semen Quality Indices in Clinical Varicocele Patients in Pakistan (original) (raw)
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Ultrasound Quarterly, 2014
Objectives: Our aim was to evaluate the effect of clinical varicocele on testicular microcirculation measured by spectral Doppler analysis and investigate the correlation between Doppler ultrasonographic findings and semen parameters. Methods: Fifty patients who received a diagnosis of clinical varicocele in the Urology Department of our university hospital were enrolled in this prospective study. Varicocele grades were determined according to sonographic parameters, and a scrotal vein with a diameter of 2.5 mm or greater on color Doppler ultrasonography was included in the study. Spectral Doppler measurements of testicular arteries (peak systolic [PSV]/end-diastolic velocity [EDV], resistivity index [RI], pulsatility index [PI]) were measured from capsular and intratesticular branches of testicular arteries. All the patients were also assessed by semen analysis. Results: Mean age was 29.08 T 5.42 years (range, 18Y45 years). Among the whole study population, 22 men had isolated left varicocele, and 28 had bilateral varicoceles. No statistically significant correlation was found between the Doppler parameters: RI, PI, and EDV, and semen analysis parameters: count, motility, volume, and morphology. On the other hand, both in unilateral and bilateral varicocele cases, PSV was found to be significantly correlated with sperm count (P G 0.05). Conclusions: Spectral Doppler analysis can provide valuable information as a noninvasive method to assess the hemodynamic changes and testicular microcirculation status in cases of clinical varicocele. However, RI, PI, and EDV values of capsular and intraparenchymal branches of testicular arteries may not be used as indicators of semen parameter deterioration. Hopefully, PSV measurement may give more conclusive data to predict sperm count. In addition, the cutoff value for this index has to be determined for future studies.
The Impact of Varicocelectomy on Testicular Arterial Blood Flow
2021
Background: The estimated incidence of varicocele is about 20% in the general population rising to almost 40% in subfertile men. Aim of the Work: to study the effect of loupe assisted sub inguinal varicocelectomy on the blood flow of the testicular artery, intratesticular artery and capsular artery, before and after three months after the operation and correlated these changes with the improvement of semen parameters. Patients and Methods: 30 patients were included in this study. 27 patients with bilateral varicocele and 3 patients with only left-sided varicocele. Clinical grading of varicocele in both sides was done before the operative procedures. Scrotal color Doppler ultrasonography, measurements of vein diameter, reflux with valsalva maneuver, and peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) for testicular, intratesticular and capsular arteries were done for all patients before and three months after varicocelectomy. Results: In the left sided varicocele, loupe assisted sub inguinal varicocelectomy resulted in statistically significant increase in PSV and EDV values for both testicular and intratesticular arteries and significant decrease of RI for both testicular and intratesticular arteries. About the capsular branch, statistically significant decrease for PSV value, EDV value and RI, 3 months after the operation; while in the right-sided varicocele, our procedure resulted in highly significant increase in both PSV and EDV values of both testicular artery and intratesticular arteries and significant decrease of RI for both testicular and intratesticular arteries. About the capsular branch, statistically significant decrease for PSV value, EDV value and RI, 3 months after the varicocelectomy operation. Conclusion: The blood flow velocity of the testicular artery (PSV, EDV) increases after microsurgical subinguinal varicocelectomy whereas the RI of the testicular artery decrease. This finding indicates that the microsurgical varicocelectomy resulted in increases the blood flow into the testis and decreases the resistance against the blood flow into the testis. We suggest that testicular blood flow parameters can be used in postoperative follow-up of patients with varicocele. In addition, there is a significant correlation between the improved testicular arterial blood flow and improvement in semen parameters after the operation.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2021
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...
Annals of Nuclear Medicine, 2005
The aim of this study was to evaluate the hemodynamics of varicocele using Doppler ultrasonography and scrotal scintigraphy, and to compare the value of these two methods in the prediction of seminal improvement after varicocelectomy. Materials and Methods: A total of 40 men with left sided varicocele presented for surgery because of infertility of at least one year in duration. Preoperative and postoperative sperm counts and per cent motility were obtained. Dynamic scrotal scintigraphy and Doppler ultrasonography were performed in all patients. Three perfusion patterns according to the time-activity curves (TAC) generated from scrotal perfusion images were defined. Type 1: radioactivity shows faster accumulation and maintenance of a higher level on the left side than on the right side. Type 2: time-activity curve rises gradually to a higher level on the left than on the right. Type 3: time-activity curve increases symmetrically and slowly on both sides. The relationship between preoperative TAC patterns and postoperative seminal findings, and preoperative Doppler grades and postoperative seminal findings were investigated. Results: Improvement in total motile sperm counts was not statistically significant (37.8% ± 3.2% versus 45.2% ± 8.5%) (p = 0.751). Following varicocelectomy, sperm concentration (million sperm per ml) increased from 16.9 ± 3.3 to 26.6 ± 8.6 (p = 0.015). According to the Doppler examinations, postoperative improvement in sperm concentration was demonstrated in patients with grade 1 varicocele (66%). Scintigraphic evaluation showed improvement in patients showing TAC-2 and TAC-3 patterns (63%). Conclusion: Local hemodynamics of varicoceles demonstrated by scintigraphy and Doppler seemed to be different. Grade 1, TAC-2 and TAC-3 patients may be better candidates for varicocelectomy. Scintigraphy and Doppler ultrasonography showed similar success rates in the prediction of improvement following varicocelectomy in the present study.
Association between varicocele grade and semen analysis parameter
Medical Journal of Indonesia
Background: Varicocele is a condition characterized by elongation, dilatation and tortuousity of spermatic vein in pampiniform plexus. Approximately 50% of infertility cases among men are caused by varicocele. The varicocele may affect the components of sperm. This study aimed to determine the association between varicocele grade based on ultrasound Doppler examination and sperm concentration, sperm motility, and sperm morphology based on semen analysis examination.Methods: This was a descriptive, cross-sectional study which used secondary data from 85 patients that visited Department of Urology, Cipto Mangunkusumo Hospital, then underwent ultrasonography examination at Department of Radiology, Cipto Mangunkusumo Hospital and semen analysis examination at Department of Obstetrics and Gynecology, Cipto Mangunkusumo General Hospital.Results: Varicocele grade was significantly associated with sperm morphology, concentration and motility (all p<0.05). Significant association was foun...
Does Varicocele Affect Testicular Arterial Blood Flow
2014
Objective: To compare the changes of testicular blood supply in the control group and patient group with varicocele and normal sperm parameters. Material and Method: 40 patients with left varicocele and 25 healthy controls were enrolled in the study. All participants were performed color Doppler sonography to assess testicular blood flow of the both right and left testes. Blood flow parameters were measured in testicular, capsular and intratesticular arteries. Semen parameters were also assessed in the participants of the patient group. Testicular blood flow parameters were compared between the two groups. Results: Mean ages of the patients and controls were respectively, 24,92±4,34 and 23,42±4,42(p>0,05). In the left testes; only the resistive index values of testicular artery were significantly lower in the patients (p=0,02). In the right testes; the resistive and pulsatility index values of testicular artery were significantly lower in the patients (p=0,01; p=0,01). Conclusion...
Bangladesh Medical Research Council Bulletin, 2018
Prevalence of varicocele is approximately 15.1% of the general population. Studies showed that surgical correction of clinically palpable varicocele could improve the semen parameters. However, there is scarce of study to demonstrate post-operative outcome of varicocelectomy among the patients with abnormal semen parameter. Therefore, this study tried to compare the microscopic changes in sperm concentration, sperm motility, and sperm morphology before and after varicocelectomy. This quasi-experimental study was done in Urology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2014 to April 2016. Forty five patients with clinically palpable varicocele were finally includedin the study. Semen parameters of these patients were assessed by following the World Health Organization′s 5th manual of semen parameter, 2010. Subinguinal varicocelectomy was performed in every case. Follow up was done three months and six months after surgery. Dat...
Journal of Clinical …, 2004
The aim of this study was to evaluate whether intratesticular arterial resistance and testicular volume differed between infertile men with subclinical varicoceles and infertile men without varicoceles. Materials and Methods. Fifty-eight infertile men were examined by gray-scale and color Doppler sonography for presence of varicocele, testicular volume, and arterial resistance. For men in the study group, mean testicular volume and resistance index (RI) in testes with varicoceles were compared with those in the contralateral testis by the paired t-test; statistical analyses between the study and control groups were performed by independent t-tests. Results. Twenty-seven men had left-sided varicoceles (96% of which were subclinical), and 31 infertile men without varicoceles served as controls. Mean volumes of the right and left testes of study subjects were 14.8 ml and 14.6 ml, respectively, and in controls were 14.2 ml and 13.6 ml, respectively. Mean RI values for the right and left testes of study subjects were 0.61 and 0.58, respectively, and in controls were 0.61 and 0.58, respectively. There were no statistically significant differences in volume or RI, either between the right and left testes within patient groups or between the control and study groups' combined mean values. While the mean intertesticular volume differences for the study and control groups were 2.2 ml and 3.4 ml, respectively, the mean intertesticular RI differences were 0.04 and 0.07, respectively. These values also did not differ significantly between the 2 groups. Conclusions. Subclinical varicocele is not associated with ipsilateral testicular atrophy, and does not affect the intratesticular arterial RI.
Mean Changes in Sperm Count in Adult Males after Varicocelectomy
Pakistan Journal of Medical and Health Sciences, 2021
Background: Varicocele, a bilateral vascular condition in which hypoxia can induce ischemic damage to both testes due to hydrostatic pressures in the venous drainage system, is a prominent cause of male infertility with a complex pathogenesis. varicocele make up 35% of primary infertility and 81% of secondary fertility. Methodology: A quasi-experimental study was conducted from January 2018 to September 2018 at urology department of Nawaz Sharif Kidney Hospital and Saidu Group of Teaching Hospitals, Swat. Sample size was 261. The study included all males between the ages of 20 and 60 who had clinically evident varicocele. Result: Results of our study P-value for pre-operative and post-operative sperm count was 0.00001 so statistically significant. According to the age distribution, 93 patients were in the age group 20-30 (35.63%), 70 patients in age group 31-40 years (27.01%), 60 patients aged 41-50 (22.98%), 38 patients aged 51 to 60 (14.26) %) are shown in Table 2. All cases had v...