Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “VARICOCELE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2002

Testicular growth arrest and adolescent varicocele: does varicocele size make a difference?

PURPOSE: We assessed whether testicular growth arrest is related to varicocele size in adolescents. We also determined whether adolescents with a varicocele and testes of equal size treated nonoperatively are at significant risk for growth arrest and, if so, whether this risk is related to varicocele size. MATERIALS AND METHODS: We retrospectively reviewed the records of boys with a varicocele. Testis volume was measured with calipers and computed into cc as (length x width x breadth) x 0.521. Testicular growth arrest was defined as left testis at least 15% smaller than the right testis. Varicocele size was graded 1-barely palpable, 2-palpable but not visible, 3a-visible and, 1 to 1.5 times the size of the ipsilateral testis, 3b-1.5 to 2 times the size of the ipsilateral testis and 3c-greater than 2 times the size of the ipsilateral testis. Boys with a grade 1 varicocele and those treated with previous inguinal or testicular surgery were excluded from study. Repair was recommended for testicular growth arrest or discomfort. Data were analyzed with chi-square and Fisher's exact test. RESULTS: The records of 124 boys 7 to 18 years old (mean age 13) with a varicocele were reviewed. Seven patients were excluded from analysis, yielding a total of 117 boys. Testicular growth arrest was observed at initial visit in 10 of 33 (30.3%) grade 2, 18 of 37 (48.6%) grade 3a, 14 of 31 (45.2%) grade 3b and 6 of 16 (37.5%) grade 3c cases (p not significant), or a total of 38 of 84 (45.2%) grade 3 cases (p <0.01) plus grade 2. Followup ranged from 1 to 5 years. Of the cases of equal sized testes at presentation growth arrest was observed in 3 of 16 (18.8%) grade 2, 2 of 11 (18.2%) grade 3a, 4 of 14 (28.6%) grade 3b and 3 of 9 (33.3%) grade 3c (p not significant), or a total of 9 of 34 (26.5%) grade 3 cases (p not significant) plus grade 2. Overall, testicular growth arrest was found in 13 of 33 (39%) grade 2 and 47 of 84 (56%) grade 3 varicoceles (p <0.01). CONCLUSIONS: Boys with a varicocele are at significant risk for testicular growth arrest, irrespective of varicocele size, and those with a grade 3 varicocele have a higher risk of testicular growth arrest than those with a grade 2 varicocele. Of boys with testes of equal size at diagnosis growth arrest is observed during adolescence in approximately 25% irrespective of varicocele size.

Adolescent↗
PubMed1984

Varicocele: reversal of the testicular blood flow and temperature effects by varicocele repair.

An experimental left varicocele was created in the adult rat by partial ligation of the left renal vein. A varicocele repair was performed by high ligation of the internal spermatic vein. Testicular blood flow and temperature changes were measured in control and sham animals, animals 30 days after establishment of varicocele and animals 30 days after varicocele repair. There was a statistically significant (p less than or equal to 0.01) bilateral elevation of testicular blood flow and temperature in the varicocele group compared to control and sham groups. Varicocele repair returned these blood flow and temperature values to normal. Average testicular blood flow for control, varicocele, sham varicocele and varicocele repair animals were 29.6 +/- 1, 39.8 +/- 2, 30.7 +/- 1 and 29.8 +/- 1 ml. per min. per 100 gm. tissue, respectively. Testicular temperatures averaged 34.4 +/- 0.1, 35.3 +/- 0.2, 34.4 +/- 0.1 and 34.5 +/- 0.1 degrees C, respectively. It is possible that the elevation in blood flow is associated with the elevation of intratesticular temperature, which is known to impair spermatogenesis. The data support a relationship between the varicocele and potential testicular damage.

Animals↗
PubMedDate not supplied

Loss of left testicular volume in men with clinical left varicocele: correlation with grade of varicocele.

It is reported that a clinical left varicocele is associated with loss of ipsilateral testicular volume. We have examined the loss of left testicular volume in infertile men with clinical left varicocele using ultrasound-derived measurements of testicular volume. We have reviewed the testicular volumes, maximum internal spermatic vein diameters, and the clinical reports of 404 men presenting for infertility evaluation at our institution between 1992 and 1996. Men with bilateral or subclinical varicoceles were excluded from the study. Subclinical varicoceles were diagnosed by the ultrasonographic demonstration of one or more veins having a maximal diameter of more than 3 mm. In men with clinical left varicocele, mean left testicular volume was less than right testicular volume (12.7 vs. 13.8 mL, P < .001). This finding was not observed in men without varicocele (12.3 vs. 12.6 mL, P > .05). In men with left varicocele, the difference between right and left testicular volume (right minus left) increased with increasing varicocele grade. Our data demonstrate that a left varicocele is associated with loss of left testicular volume. The results also show that the degree of left testicular hypotrophy is proportional to the clinical grade of the varicocele.

Humans↗
PubMed2000

The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents.

OBJECTIVE: To determine the prevalence and site of varicocele and varicocele-related testicular atrophy in children and adolescents. PATIENTS AND METHODS: The study included 4052 boys aged of 2-19 years, divided into four age groups; the findings of a physical examination, any testicular atrophy and testicular volume were recorded. RESULTS: Varicocele was detected in 293 (7.2%) of the 4052 boys; the prevalence was 0.79% in those aged 2-6 years, 0.96% at 7-10 years, 7.8% at 11-14 years and 14.1% at 15-19 years. The prevalence was 0.92% in 1232 children aged 2-10 years and 11.0% in 2531 adolescents aged 11-19 years (P < 0.001). The prevalence increased significantly at age 13 years (P < 0.005). The varicocele was unilateral in 263 of the 293 (89.7%) boys with varicocele; of these, one (0.38%) was on the right and the others on the left side. Varicoceles were bilateral in 30 of 279 boys (10.8%) aged 11-19 years but none were detected in those aged < 11 years. Varicocele-related testicular atrophy was not present in those aged < 11 years, but seven boys (7.3%) aged 11-14 years and 17 (9.3%) aged 15-19 years had testicular atrophy. The difference in prevalence between the last two age groups with atrophy was not significant. CONCLUSION: These findings support the view that varicocele is a progressive disease and that the prevalence of varicocele and testicular atrophy increases with the puberty.

Adolescent↗
PubMed1994

The venous anatomy of experimental left varicocele: comparison with naturally occurring left varicocele in the human.

OBJECTIVE: To determine the effect of experimental left varicocele on the anatomy of the veins serving the rat testis and to compare that anatomy to known patterns of vascular drainage from the human testis with and without varicocele. DESIGN: Vascular maps were made of the effluent vessels from the rat testis in control animals and those with a 30-day experimental left varicocele. Consensus maps were arrived at and these were compared to published reports of the pertinent venous anatomy in humans with and without varicocele. SETTING: Research laboratory. RESULTS: The major route of blood leaving the rat testis was confirmed to be the spermatic vein, but nine common collaterals were also found to exist. Four of these collaterals became more pronounced with experimental varicocele as did several dilated perineal veins. These latter vessels all led to the iliac vein. The vasculature of the rat experimental varicocele model shares some important anatomical features with human varicocele anatomy. CONCLUSIONS: Varicocele in humans and in the rat model causes a redistribution of blood flow from a route primarily out the spermatic vein to routes leading to the iliac vein. The redistribution is similar but not identical.

Animals↗
PubMed2002

The effect of varicocele repair on testicular volume in children and adolescents with varicocele.

PURPOSE: We investigated the effect of varicocele repair on testicular volume according to age in children and adolescents and review the long-term results of varicocele surgery. MATERIALS AND METHODS: The study included 39 boys 11 to 19 years old with clinical palpable varicocele who underwent varicocele surgery with at least 1 year of postoperative followup. Preoperative and postoperative testicular volumes were monitored and measured with an ellipsoid Prader orchidometer. Physical examination findings (testicular volumes and testicular consistency) in all boys, and serum hormone values and semen parameters in 16 adolescents were recorded and compared before and after surgery. RESULTS: Left unilateral varicocelectomy was done in 29 boys (74%) and bilateral varicocelectomy in 10 (26%). While no postoperative hematoma, infection or testicular atrophy was observed, 1 boy (2.5%) had varicocele recurrence and 2 boys (5.1%) had minimal hydroceles that required no intervention. Significant increases were observed in postoperative sperm concentration (p = 0.01), total motile sperm count (p = 0.009), testis volume (p = 0.000) and serum testosterone level (p = 0.014). All 15 boys with preoperative soft testis had normal testicular consistency postoperatively. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. When comparing preoperative to postoperative increase in testicular volume according to age in all boys, the mean was statistically significantly higher in boys younger than 14 years (left testis p = 0.037, right testis p = 0.000). CONCLUSIONS: Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. While there was catch-up growth in comparison to the contralateral testis, testicular consistency improved but testicular volumes may not increase significantly after varicocele repair at ages older than 14 years. However, in these adolescents postoperative semen parameters and serum hormone values may significantly improve regardless of testicular volume. Therefore, boys with varicocele and their families should be fully informed in light of these findings.

Adolescent↗
PubMed1994

Prevalence of sperm bound antibodies in infertile men with varicocele: the effect of varicocele ligation on antibody levels and semen response.

An increased level of antisperm antibodies has been demonstrated in infertile men with varicocele compared with normal fertile men, suggesting a possible cause and effect relationship. To evaluate the possible etiological role of antisperm antibodies in varicocele patients, we performed a prospective study of 32 infertile men undergoing varicocele ligation. Semen analyses and antisperm antibodies as measured by the immunobead test were performed preoperatively and postoperatively at 3 and 6 months. Of the infertile men with varicocele 28% had a positive immunobead test compared with 0% of normal fertile men. The average total motile sperm count was significantly different (p < 0.05, 2-tailed t test) for 9 varicocele patients with sperm-bound antibody (3.2 x 10(6)) compared with 23 without antibody (8.4 x 10(6)). Postoperatively, 68% of all patients exhibited improved semen parameters, with no change in antibody status in either group. Among the antibody positive group 71% showed an increase in motile sperm per ml. of 2.8 x 10(6) to 17.2 x 10(6) (525% increase, p < 0.05), while in the antibody negative group 67% showed an increase of 3.8 x 10(6) to 24.9 x 10(6) (553% increase, p < 0.05). Our study suggests that there is an increased incidence of sperm-bound immunoglobulin in infertile varicocele patients and an apparent adverse effect on semen parameters in these patients. However, the presence of sperm-bound immunoglobulin did not affect the percentage response to surgical correction, nor can we postulate an immunological mechanism as a major etiological factor in varicocele induced infertility.

Adult↗
PubMed1982

Clinical experience with the radioisotope varicocele scan as a screening method for the detection of subclinical varicoceles.

The association of varicoceles and subfertility has been well documented. Although varicoceles remain the most common surgically correctable cause of male infertility the diagnosis of small varicoceles remains a challenge. We evaluated 40 men with an isotope blood pooling scan. Seven volunteers served as either positive or negative controls. Complete correlation between physical findings and the isotope scan was found. The 6 patients with obvious clinical varicoceles and a stress pattern on semen analysis all had positive scans. The 18 patients with a stress pattern and who were clinically suspected of having a varicocele all had positive scans. Of 9 patients evaluated for infertility with a stress pattern but no clinical evidence of varicocele 6 had positive scans. We believe that the isotope scan will prove to be a useful procedure in the detection of nonpalpable varicoceles in selected subfertile men.

Adult↗
PubMed2003

The efficacy of bilateral varicocelectomy in patients with palpable bilateral varicoceles: comparative study with unilateral varicocele.

To determine whether the beneficial effect of bilateral varicocelectomy for bilateral varicoceles is similar to that of unilateral varicocelectomy for unilateral varicoceles, we compared the effect of varicocelectomy in men with unilateral and bilateral palpable varicoceles. Seventy-five men with unilateral varicocele and 34 with bilateral varicoceles were included in this study. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, and estradiol were measured in morning blood specimens. Unilateral varicocelectomy was performed for unilateral and bilateral varicocelectomy for bilateral varicoceles using a microsurgical technique. The seminogram was determined every 3 months for up to 18 months. There were no significant differences in the change in the sperm concentration between the unilateral and bilateral groups. Sperm concentration before surgery in unilateral and bilateral group was 8.0+/-5.0x10(6)/ml and 8.1+/-4.9x10(6)/ml, respectively. Eighteen months after surgery, the sperm concentration significantly increased to 23.4+/-15.8x10(6)/ml and 26.9+/-24.6x10(6)/ml in unilateral and bilateral group, respectively. Preoperative motility in the unilateral and bilateral group was 38.9+/-15.2% and 39.6+/-15.7%, respectively. Eighteen months after operation, sperm motility had increased and was similar in the two groups, 43.1+/-19.2% and 45.4+/-17.6%. Sperm morphology was unaffected by surgery in either group. Improvement in the seminogram of patients following bilateral varicocelectomy was comparable to that in patients with unilateral varicocelectomy. Bilateral repair for bilateral varicocelectomies is justified for patients who desire improved spermatogenesis.

Adult↗
PubMed1983

Testicular arterial perfusion in varicocele: the role of rapid sequence scintigraphy with technetium in varicocele evaluation.

Rapid sequence scintigraphy was used to study testicular arterial perfusion and venous stasis in 53 patients with varicocele-associated infertility, 17 with idiopathic testicular failure and 9 treated for varicocele. Arterial blood supply to the diseased testicle was decreased in 63 per cent of the patients with subclinical or low grade varicocele compared to 18 per cent with idiopathic testicular failure. In the majority of cases the disturbance of perfusion disappeared immediately after interruption of retrograde blood flow in the internal spermatic vein by transcatheter embolization, whereas persistently impaired perfusion was found in a few cases with no improvement of semen quality after treatment. Venous stasis was found in only 18 per cent of the patients with low grade varicocele compared to 88 per cent with large varicoceles. It is suggested that impaired arterial blood supply rather than venous stasis is the pathogenic factor in epididymo-testicular dysfunction associated with low grade varicocele.

Humans↗
PubMed1986

[Noninvasive imaging procedures in the diagnosis and therapy control of varicoceles. I: Sonography and thermography in the diagnosis of varicoceles].

69 patients with clinically suspected varicoceles were examined thermographically and sonographically prior to testicular phlebography. The combination of sonography and thermography permitted precise differentiation into normal findings (7%), left-sided varicoceles (86%) and bilateral varicoceles (7%). Thermography was advantageous with an accuracy of 97.3%. Sonography had an accuracy of 90.5%. No clear correlation was found between varicocele size and degree of hyperthermia. The combination of sonography and thermography affords a high degree of accuracy in the diagnosis of varicoceles, including subclinical and infantile varicoceles.

Adolescent↗
PubMedDate not supplied

Varicocele as a progressive lesion: positive effect of varicocele repair.

Varicoceles are the leading correctable cause of infertility in men who present to an infertility clinic for evaluation. Consequently, the surgical correction of a varicocele, known as a varicocelectomy, is the most commonly performed operation for the treatment of male infertility. The current data suggest that an individual with a varicocele, even with a previously normal semen analysis or documentation of previous fertility, is at risk for subsequent loss of testicular function and infertility. Many of these patients will need to be treated because there is convincing evidence that a varicocele may have a progressive toxic effect on the testes that may ultimately result in irreversible infertility if left untreated. Identifying those individuals with varicoceles that will ultimately cause fertility impairment is still beyond our current clinical capabilities. Current investigative modalities, e.g. semen analysis, testicular measurement, serum gonadotrophin determination, gonadotrophin-releasing hormone (GnRH) stimulation test, and testis biopsy analysis, may be employed to detect early changes in testicular physiology produced by a varicocele.

Hormones↗
PubMed1990

Improvement of semen characteristics after surgical repair of bilateral testicular varicocele as compared to unilateral varicocele patients.

The operative treatment for surgical repair of bilateral testicular varicoceles was evaluated in terms of the improvement achieved in the sperm density and percentage progressive motile sperm. These parameters were compared for 27 cases of bilateral varicocele diagnosed by palpation and subjected to bilateral high ligation of the internal spermatic vein and for 40 cases of left unilateral testicular varicocele. There were no significant differences in preoperative values (such as sperm density; progressive motile sperm; serum levels of luteinizing hormone, follicle-stimulating hormone, and testosterone; and Johnson's score count) between the bilateral and unilateral testicular varicocele groups. The improvement in postoperative sperm density in the cases with bilateral testicular varicocele was apparently less satisfactory than in the cases with testicular varicocele only on the left side.

Adult↗
PubMedDate not supplied

Surgical repair of secondary right varicocele in rats with primary left varicocele: effects on fertility, testicular temperature, spermatogenesis, and sperm maturation.

To evaluate whether or not dilation of the right testicular vein is a constant finding in animals with left varicocele and to illustrate its contribution to the detrimental effect of a left varicocele on the right testis, an experimental varicocele model was produced in 40 rats. Ten other rats had a sham operation (group A). Seven weeks after the operation, all 50 rats underwent laparotomy and dilation of both testicular veins was seen in 23 rats, which were randomly assigned to group B (n = 11) and group C (n = 12). One week later, groups A and C underwent sham ligation of the right testicular vein, whereas group B rats underwent resection of this vein. At 84 days after the initial operation, group C rats showed a significant reduction in right epididymal sperm content, motility, and fertilizing capacity, right testicular weight, and right testicular vs. intraabdominal temperature difference when compared with groups A and B. Since surgical repair of the secondary right varicocele improved all the parameters indicating the harmful consequences of the primary left varicocele on the right testis, it appears that dilation of the right testicular vein contributes to the detrimental effect of a left varicocele on the right testis.

Animals↗
PubMed1990

[Male varicocele. Analysis of the incidence of varicocele in a population of 18,800 young men].

The authors evaluate the incidence of varicocele after having examined 18,800 healthy white men members of the Italian Army Corps born in 1966 and visited in 1985. They found a varicocele in 775 patients (4.12%), in 5 was present bilaterally, and in 770 in the left side. In 45 patients the surgical treatment was already done at the time of the examination and there were 3 recurrences. The patients with varicocele were divided according to the classification of Dubin-Amelar and were: grade I n. 175 (0.93%); grade II n. 515 (2.74%); grade III n. 35 (50.18%). In 566 (73.03%) the diagnosis was done at the moment of the examination, 152 (19.62%) discovered the varicocele at the self examination; in 57 (7.37%) the diagnosis was already done by the family doctor. Infertility is sometime associated to the varicocele and with the unrelieved local discomfort are the main indications for surgery. It should be also emphasized the need of education on the infertility problems during the high school that is a time of the life in which there is the highest incidence of varicocele.

Adult↗
PubMed1987

[Diagnosis of varicocele with bidirectional Doppler sonography. A contribution to the pathogenesis of varicocele].

A total of 375 patients with varicocele were examined by bidirectional Doppler sonography. Venous reflux was classified as one of two Doppler grades: spontaneous reflux and Valsalva-induced reflux. The Doppler grades were compared with clinical aspects (e.g. size) of the varicocele. Using bidirectional recording, it is possible to describe two hemodynamically different types of varicoceles (the pressure type and the shunt type). On the basis of the Doppler results the pathogenesis of varicocele can be determined. Spontaneous reflux causes the shunt type and the medium-sized and large varicocele, while Valsalva-induced reflux causes the pressure type or the stop type and the small and subclinical varicocele.

Blood Flow Velocity↗
PubMed1986

Hemodynamics of the varicocele. Part II. Correlation among the results of renocaval pressure measurements, varicocele scintigraphy and phlebography.

Left renal vein compression occurring mainly with the patient in the upright position, and being less severe or absent in the supine position, was considered to be the main cause of varicoceles. We show that left renal vein compression is, indeed, more severe with the patient in the upright than in the supine position and that it produces a left renocaval pressure gradient that is responsible for the retrograde blood flow in the left testicular vein. This pressure gradient, which was determined in the supine and semierect positions in 34 patients, increased from a mean of 3.8 mm. Hg in the supine position to a mean of 7.8 mm. Hg in the semierect position. On the basis of the assumption that the renocaval pressure gradient measured with the patient in the semierect position determines the presence and velocity of a retrograde flow in the left testicular vein, as shown by the dynamic portion of the varicocele scintigram (see part I), these variables were analyzed and the correlation coefficient proved to be good. Therefore, we conclude that the varicocele occurs when the left testicular vein lacks valves or there is a renogonadal bypass, and the severity of the left renal vein compression in the (semi) upright position determines the velocity of the retrograde flow in the left testicular vein and the size of the varicocele.

Blood Pressure↗
PubMed1992

Surgical repair versus medical treatment of varicocele in the rat: pharmacological manipulation of the varicocelized testicle.

Human chorionic gonadotropin, kallikrein, indomethacin, and hydralazine were administered to different groups of varicocelized rats, while surgical repair of the varicocele was performed in another group of rats. The effects of conservative and surgical treatment on epididymal sperm content and motility, the weights of the testes, epididymis, and male accessory genital glands, and fertility were compared between each group and a sham-treated group of rats. Surgical repair significantly improved all the evaluated parameters and all the conservative regimens, except hydralazine, resulted in a significant improvement in most parameters. Our results indicate that stimulation of the Leydig or/and Sertoli cells of a varicocelized testicle can counteract some of the detrimental consequences of the varicocele itself.

Animals↗