Database : MEDLINE Search on : varicocele [Words] References found : 3935 [refine] Displaying: 1 .. 10   in format [Detailed]

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[PMID]: 23658867 [Au] Autor: Park YW; Lee JH [Ad] Address: Department of Urology, National Police Hospital, Seoul, Korea. [Ti] Title: Preoperative predictors of varicocelectomy success in the treatment of testicular pain. [So] Source: World J Mens Health;31(1):58-63, 2013 Apr. [Is] ISSN: 2287-4208 [Cp] Country of publication: Korea (South) [La] Language: eng [Ab] Abstract: PURPOSE: We performed the present study to evaluate the prognostic factors for the surgical outcome of varicocelectomy in the treatment of a painful varicocele. MATERIALS AND METHODS: A total of 77 patients undergoing varicocelectomy were enrolled. All the patients were examined for body mass index (BMI), varicocele grade, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), semen analysis, maximal vein diameter, and discrepancy of testicular volume. At a follow-up visit 3~6 months after the surgery, the patient response was graded as a complete response, partial response, or no response. The resolution of pain was defined as a complete or partial response. We used logistic regression analyses to determine the preoperative factors for predicting a complete response and the resolution of pain. RESULTS: Ten subjects were lost to follow-up. The remaining 67 patients were included in this study. The pain was completely resolved in 47.8% of patients, partial resolution was observed in 25.4% of patients, and failure was reported in 26.9% of patients. Among the parameters, only a longer duration of pain (≥3 months) was an independent factor related to the complete response of pain (odds ratio, 7.371; p=0.010) and the resolution of pain (odds ratio, 7.209; p=0.042). The parameters of semen analysis results, testosterone, LH, FSH, BMI, grade, ultrasonography results, and the type of surgical approach did not significantly predict the resolution of pain. CONCLUSIONS: The duration of pain (≥3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Cu] Class update date: 130513 [Lr] Last revision date: 130513 [Da] Date of entry for processing: 130509 [St] Status: PubMed-not-MEDLINE [do] DOI: 10.5534/wjmh.2013.31.1.58

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[PMID]: 23658861 [Au] Autor: Choi WS; Kim SW [Ad] Address: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. [Ti] Title: Current issues in varicocele management: a review. [So] Source: World J Mens Health;31(1):12-20, 2013 Apr. [Is] ISSN: 2287-4208 [Cp] Country of publication: Korea (South) [La] Language: eng [Ab] Abstract: The most common cause of male infertility is varicocele, and varicocele is the most common correctable cause of male factor infertility. In this article we reviewed the concept of varicocele in terms of its diagnosis, method of treatment, indications for treatment, treatment outcomes, and prognostic factors. Physical examination is an essential diagnostic tool in the evaluation of a patient with a varicocele. However, as it depends on subjective findings, standardization of the physical examination method is needed. Various methods for treatment of varicocele exist, including open surgical, laparoscopic, microscopic surgical, and radiologic treatment such as embolization. Among these treatment approaches, microscopic inguinal or subinguinal varicocelectomy has superior outcomes, with a low complication rate. The influence of the treatment of varicocele on fertility is still a controversial issue and a difficult question to address, because there are limitations to performing a randomized control study, and previous studies had a heterogeneity of subjects and high dropout rate. However, there is robust evidence that varicocelectomy improves semen parameters as a surrogate marker of the potential for fertility. To date, general indications for treatment of varicocele are limited in patients with proven infertility, clinical palpable varicocele, and abnormal semen characteristics. Recently, it was shown that some symptoms other than infertility could be an indication for varicocelectomy because these symptoms are frequently related to deterioration of semen parameters. Varicocele in the adolescent presents a more difficult decision regarding whether to treat. A testicular size discrepancy of more than 20% is helpful for treatment decisions. Various prognostic factors were noted in several studies without, however, a consistent consensus. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Cu] Class update date: 130513 [Lr] Last revision date: 130513 [Da] Date of entry for processing: 130509 [St] Status: PubMed-not-MEDLINE [do] DOI: 10.5534/wjmh.2013.31.1.12

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[PMID]: 23500035 [Au] Autor: Kolon TF [Ad] Address: Department of Urology (Surgery), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. [Ti] Title: The adolescent varicocele-a shakespearean tragedy or much ado about nothing? [So] Source: J Urol;189(6):2024-5, 2013 Jun. [Is] ISSN: 1527-3792 [Cp] Country of publication: United States [La] Language: eng [Pt] Publication type: EDITORIAL [Em] Entry month: 1305 [Js] Journal subset: AIM; IM [St] Status: In-Data-Review

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[PMID]: 23261480 [Au] Autor: Bogaert G; Orye C; De Win G [Ad] Address: University Hospital Leuven, Leuven, Belgium. Electronic address: guy.bogaert@uzleuven.be. [Ti] Title: Pubertal Screening and Treatment for Varicocele do not Improve Chance of Paternity as Adult. [So] Source: J Urol;189(6):2298-304, 2013 Jun. [Is] ISSN: 1527-3792 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: PURPOSE: We investigated the eventual positive effects of early screening and treatment for varicocele in pubertal boys without symptoms to determine their chance of paternity later in life. It has not been proved if the presence of varicocele during puberty has an influence on later fertility or paternity. However, since an influence is believed to exist, beginning in 1987 the Belgian Society of Pediatrics has recommended screening all boys 12 to 17 years old during their yearly medical examination and referral for followup or treatment if varicocele is detected. At our clinic patients and their parents were informed about and able to choose between varicocele treatment (antegrade sclerotherapy) and observation. We subsequently contacted these patients, who are now older than 30 years, and inquired about their paternity. MATERIALS AND METHODS: We selected for this study pubertal boys 12 to 17 years old with a varicocele who were referred by screening pediatricians to our pediatric urology clinic between 1989 and 2005. We excluded patients with bilateral or unilateral right varicocele and patients with other medical problems that could influence fertility. A total of 661 patients were eligible for the study. Minimally invasive treatment of varicocele, ie antegrade sclerotherapy (with the patient under local or general anesthesia), was offered but not required. Of the patients 372 underwent treatment (mean age 15.3 years, median 15.6) and 289 were followed conservatively (mean age 17.1, median 16.4). All patients were contacted twice by letter and, if no response was received, once by telephone. Patients were asked about paternity, time to conception and whether they had visited a fertility center. RESULTS: Of the 361 respondents 158 (43%) had an active desire to have a child. Paternity was achieved in 85% of the conservatively followed group and 78% of the active treatment group (p >0.05). CONCLUSIONS: There is no beneficial effect of pubertal screening and treatment for varicocele regarding chance of paternity later in life. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: AIM; IM [St] Status: In-Data-Review

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[PMID]: 23201383 [Au] Autor: Zalata AA; Mokhtar N; Badawy Ael-N; Othman G; Alghobary M; Mostafa T [Ad] Address: Medical Biochemistry Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt. [Ti] Title: Androgen receptor expression relationship with semen variables in infertile men with varicocele. [So] Source: J Urol;189(6):2243-7, 2013 Jun. [Is] ISSN: 1527-3792 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: PURPOSE: Androgen receptor, a member of the nuclear receptor superfamily, has important roles in male reproductive function. It is required for sexual differentiation, pubertal development, spermatogenesis regulation, meiosis completion and spermatocyte transition to haploid round spermatids. We assessed the association of androgen receptor expression and semen variables in infertile men with varicocele. MATERIALS AND METHODS: A total of 299 men were grouped into healthy, fertile controls, infertile men without varicocele and men with infertility associated with varicocele. A history was obtained, clinical examination and semen analysis were done and reproductive hormones were estimated. Androgen receptor expression and the acrosome reaction were determined in recovered spermatozoa. RESULTS: Androgen receptor expression was significantly decreased in infertile men with varicocele more than in infertile men without varicocele compared to fertile controls. Androgen receptor correlated positively with sperm count, motility, normal forms, velocity, linear velocity, acrosome reaction and α-glucosidase. It correlated negatively with serum follicle-stimulating hormone and estradiol. Multiple stepwise regression analysis of androgen receptor expression revealed that the sperm acrosome reaction and linearity index were the most affected independent variables. CONCLUSIONS: Androgen receptor expression was significantly decreased in infertile men with varicocele more than in infertile men without varicocele compared to fertile men. Androgen receptor expression correlated positively with sperm count, motility, normal forms, velocity, linear velocity and acrosome reaction. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: AIM; IM [St] Status: In-Data-Review

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[PMID]: 23388377 [Au] Autor: Chamberlain CA; Martin RM; Busby J; Gilbert R; Cahill DJ; Hollingworth W [Ad] Address: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK. charlotte.chamberlain@bristol.ac.uk [Ti] Title: Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders. [So] Source: BMC Public Health;13:112, 2013. [Is] ISSN: 1471-2458 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: BACKGROUND: National Institute for Health and Clinical Excellence (NICE) clinical guidelines and subsequent NICE issued 'recommendation reminders' advocate discontinuing two fertility procedures and caesarean sections in women with hepatitis. We assess whether NICE guidance in 2004 and recommendation reminders were associated with a change in the rate of clinical procedures performed. METHODS: Routine inpatient Hospital Episode Statistics (HES) data were extracted from the HES database for 1st April 1998 to 31st March 2010 using OPCS procedure codes for varicocele operations in infertile men, endometrial biopsies in infertile women and caesarean sections in women with hepatitis B or C. We used Joinpoint regression to identify points in time when the trend in procedure rates changed markedly, to identify any influence of the release of NICE guidance. RESULTS: Between 1998-2010, planned caesarean sections in women with and without hepatitis B or C increased yearly (annual percentage change (APC) 4.9%, 95% CI 2.1% to 7.7%) in women with hepatitis, compared with women without (APC 4.0% [95% CI 2.7% to 5.3%] up to 2001, APC -0.6% [95% CI -2.8% to 1.8%] up to 2004 and 1.3% [95% CI 0.8% to 1.8%] up to 2010). In infertile women under 40 years of age, endometrial biopsies for investigation of infertility increased, APC 6.0% (95% CI 3.6% to 8.4%) up to 2003, APC 1.5% (95% CI -4.3% to 7.7%) to 2007 followed by APC 12.8% (95% CI 1.0% to 26.0%) to 2010. Varicocele procedures remained relatively static between 1998 and 2010 (APC -0.5%, 95% CI -2.3% to 1.3%). CONCLUSIONS: There was no decline in use of the three studied procedures, contrary to NICE guidance, and no change in uptake associated with the timing of NICE guidance or recommendation reminders. 'Do not do' recommendation reminders may be ineffective at improving clinical practice or achieving disinvestment. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1304 [Js] Journal subset: IM [St] Status: In-Process [do] DOI: 10.1186/1471-2458-13-112

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[PMID]: 22595747 [Au] Autor: Meij-de Vries A; den Bakker FM; van der Wolf-de Lijster FS; Meijer RW; Goede J; Heij HA [Ad] Address: Alkmaar Medical Centre, Department of Surgery, Postbus 501, 1800 AM Alkmaar, The Netherlands. Electronic address: ann.devries@vumc.nl. [Ti] Title: High prevalence of intratesticular varicocele in a post-orchidopexy cohort. [So] Source: J Pediatr Urol;9(3):328-33, 2013 Jun. [Is] ISSN: 1873-4898 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: PURPOSE: Intratesticular varicocele (ITV) is an uncommon sonographic finding. A prevalence of up to 2% has been reported in men with testicular problems. In a cohort of men who had undergone prepubertal orchidopexy for acquired undescended testis, several cases of ITV were found. The aim of this study was to analyse the prevalence and clinical aspects of ITV in this cohort. METHODS: In a long-term follow-up study of position and growth of undescended testis after prepubertal orchidopexy, ultrasonography was used to identify men with ITV. Data on clinical presentation, testicular volume, and the location, size and Doppler aspects of intratesticular varicocele were collected and analysed. RESULTS: Of the 105 men, 9 were identified with ITV (8.6%). In all patients, the side of orchidopexy correlated with the side of the ITV, and all were left-sided. The testis with ITV had a smaller volume than the testis without ITV (p = 0.026). CONCLUSIONS: A remarkably high prevalence of ITV (8.6%) was found as well as a smaller volume of the testes with ITV in a cohort of men who had undergone prepubertal orchidopexy for acquired undescended testis. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23661519 [Au] Autor: Pajovic B; Radojevic N [Ad] Address: Faculty of Medicine, University of Montenegro, Urology and Nephrology Clinic, Clinical Centre of Montenegro, Podgorica, Montenegro. com_nr@yahoo.com. [Ti] Title: Prospective follow up of fertility after adolescent laparoscopic varicocelectomy. [So] Source: Eur Rev Med Pharmacol Sci;17(8):1060-3, 2013 Apr. [Is] ISSN: 1128-3602 [Cp] Country of publication: Italy [La] Language: eng [Ab] Abstract: BACKGROUND: Varicocele associated with infertility has been recognized for years. Referential literature provides few papers, even meta-analyses which did not confirm the success of surgery related to the increasing of the semen quality. AIM: The purpose of the presented paper is referred in arising the quantum of knowledge related to usefulness of surgery in varicocele treatment. PATIENTS AND METHODS: The varococele incidence was established in premature age (7-18) in population of 969 boys. In those who suffered from varicocele, we estimated their semen analysis parameters before and three months after the surgery, and followed up the pregnancy rate in surgically treated subjects many years after the treatment. RESULTS: A prevalence of 9.7% in premature age, significantly raising in the group aged 15-18 was showed. After the laparoscopic varicocelectomy, all of the semen parameters (left testicular volume, pH, sperm count, abnormal forms and viability) were improved, since the semen volume and the progressive motility not significantly. Since we observed adolescent varicocele, some of the semen parameters initialy have not been out of reference limits. Following the surgically treated subjects for next 12-17 years, the pregnancy rate is at least 75%, since not all of them have been married yet. CONCLUSIONS: We recorded improvement of two out of three parameters of fertility after the operation in a group of 23 surgically treated patients. This fact encourages those who advocate surgical treatment of varicocele in adolescents, since the early therapy would prevent fertility disorders. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23503958 [Au] Autor: Inci K; Gunay LM [Ad] Address: Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. kuinci@hacettepe.edu.tr [Ti] Title: The role of varicocele treatment in the management of non-obstructive azoospermia. [So] Source: Clinics (Sao Paulo);68 Suppl 1:89-98, 2013. [Is] ISSN: 1980-5322 [Cp] Country of publication: Brazil [La] Language: eng [Ab] Abstract: The literature on male reproductive medicine is continually expanding, especially regarding the diagnosis and treatment of infertility due to non-obstructive azoospermia. The advent of in vitro fertilization with intracytoplasmic sperm injection has dramatically improved the treatment of male infertility due to nonobstructive azoospermia. Assisted reproduction using testicular spermatozoa has become a treatment of hope for men previously thought to be incapable of fathering a child due to testicular failure. In addition, numerous studies on non-obstructive azoospermia have reported that varicocelectomy not only can induce spermatogenesis but can also increase the sperm retrieval rate; however, the value of varicocelectomy in patients with non-obstructive azoospermia still remains controversial. The purpose of this review is to present an overview of the current status of varicocele repair in men with non-obstructive azoospermia. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1303 [Js] Journal subset: IM [St] Status: In-Process

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[PMID]: 23477168 [Au] Autor: Söylemez H; Penbegül N; Atar M; Bozkurt Y; Sancaktutar AA; Altunoluk B [Ad] Address: Dicle University, Medical Faculty, Department of Urology, Diyarbakir, Turkey. drhaluks@yahoo.com [Ti] Title: Comparison of laparoscopic and microscopic subinguinal varicocelectomy in terms of postoperative scrotal pain. [So] Source: JSLS;16(2):212-7, 2012 Apr-Jun. [Is] ISSN: 1086-8089 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: BACKGROUND AND OBJECTIVES: In this study, 2 different varicocelectomy methods were compared with regard to postoperative scrotal pain, length of operation, and complications. METHODS: Forty varicocele patients, who visited our clinic because of infertility or scrotal pain between 2008 and 2009, were enrolled in this clinical study. Microscopic subinguinal varicocelectomy was performed on 20 patients in Group I, and laparoscopic varicocelectomy was performed on 20 patients in Group II. Following surgery, the patients were assessed for postoperative requirements for analgesia; return to normal activity; varicocele recurrence; hydrocele formation; scrotal pain at postoperative days 1, 3, and 7; and other complications. RESULTS: Mean age was 24.2 +/- 3.4 years in Group I and 25.1 +/- 2.1 years in Group II. Mean pain scores at postoperative 1, 3, and 7 days in Group I were (5.20 +/- 1.14, 4.60 +/- 0.97, and 3.50 +/- 0.97, respectively) significantly higher than those of Group II (0.70 +/- 0.82, 0.60 +/- 0.84, and 0.10 +/- 0.32, respectively). Time to return to normal activity was significantly shorter in Group II (3.7 +/- 2.1 days) compared with Group I (6.8 +/- 3.4 days) (p = 0.028). However, the number of recurrences and hydroceles, as a complication of varicocelectomy, was 2 times higher in Group II (10%) than in Group I (5%). CONCLUSIONS: We believe that laparoscopic varicocelectomy is a safe, effective, and minimally invasive procedure. Furthermore, reduced postoperative discomfort and earlier return to normal activity are additional advantages of this method. [Mh] MeSH terms primary: Pain, Postoperative/epidemiology Urologic Surgical Procedures, Male/methods Varicocele/surgery [Mh] MeSH terms secundary: Adult Humans Laparoscopy Male Pain Measurement Scrotum Surgical Instruments Young Adult [Pt] Publication type: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Entry month: 1304 [Cu] Class update date: 130509 [Lr] Last revision date: 130509 [Js] Journal subset: IM [Da] Date of entry for processing: 130312 [St] Status: MEDLINE

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