Sneeze and pop: a ruptured varicocele; analysis of literature, guided by a well-documented case-report

lncRNA and mRNA sequencing of the left testis in experimental varicocele rats treated with Morinda officinalis polysaccharide

Varicocele is a common disease of the male reproductive system. Morinda (M.) officinalis is a Chinese herbal medicine, whose main bioactive component M. officinalis polysaccharide (MOP) is believed to have a therapeutic effect on varicocele; however, the underlying molecular mechanisms of this effect are poorly understood. In the present study, 24 rats were randomly divided into three groups: i) Control group; ii) experimental varicocele group; and iii) 300 mg/kg MOP administration group. Analysis of mRNA and long non-coding RNA (lncRNA) expression in rat left testicular tissue was performed. The results suggested that a total of 144 mRNAs and 63 lncRNAs, 63 mRNAs and 148 lncRNAs, and 173 mRNAs and 54 lncRNAs were differentially expressed between the varicocele non-treatment and control groups, the varicocele treatment and varicocele non-treatment groups, and the varicocele treatment and control groups, respectively. Following validation by reverse transcription-quantitative PCR, the Yip1 domain family member 7 (YIPF7) gene was identified as a key mediator of varicocele pathogenesis and repair effect of MOP. Additionally, genes such as purinergic receptor P2X 4 (P2RX4), transmembrane protein 225B (TMEM255B) and Wnt family member 9B (WNT9B) were confirmed to be differentially expressed between the varicocele non-treatment and control groups. We hypothesize that TMEM255B could be a potential novel diagnostic biomarker for varicocele; WNT9B and P2RX4 likely play notable roles in the pathophysiology of the disease through the Wnt signaling pathway and regulation of transmembrane ion channels, respectively. In summary, the present study delineated the molecular mechanisms underlying varicocele pathogenesis and the therapeutic effect of MOP, identified a potential novel diagnostic marker and therapeutic target for varicocele, and provided feasible directions for further studies in the future.

Sonographic Evaluation of Pelvic Venous Disorders

ABSTRACT

Pelvic venous disorders are a group of interrelated conditions characterized by venous incompetence. These conditions often manifest with nonspecific symptoms that overlap with many gynecological, gastrointestinal, and urologic diseases. Clinical diagnosis can be difficult, and imaging can play a vital role in differentiating etiology. Sonographic evaluation is often the first step in evaluating these symptoms. Special attention to possible underlying pelvic venous disorders can reveal characteristic findings, support diagnosis, and guide treatment. Here we review pelvic congestion syndrome, nutcracker syndrome, May-Thurner syndrome, and other venous disorders, with a specific focus on sonographic findings and considerations.

Synergetic effect of hookah smoking on varicocele-associated male reproductive impairment in the Saudi community in Al Jouf region, Saudi Arabia

PURPOSE

The aim of this study is to explore the clinical relationship between the varicocele-associated male infertility with hookah smoking practice in the Saudi community in the al Jouf region.

MATERIALS AND METHODS

A total of 192 patients were categorized into two groups; varicocele with (Varicocele-Associated Hooka (VH) group; n = 100) and without smoking (NHV group; n = 92). Laboratory investigations such as hormonal (follicle-stimulating hormone, and luteinizing hormone [LH]), semen analysis were performed. Ultrasonography-based varicocele screening was performed. Data were analyzed with SPSS version 21.0. P < 0.05 was considered statistically significant.

RESULTS

Increased prevalence of varicocele Grade 2 (57%) and Grade 3 (52.5%) in HV groups. In contrast, Grade 1 was increased in NHV group (55.6%). A significant (P = 0.05) decrease in testosterone levels in the HV group (2.83 ± 0.21) as compared to NHV group (2.33 ± 0.07) observed. Decreased levels of sperm count (21.96 ± 6.31) and sperm morphology (14.09 ± 0.45) were observed in HV groups as compared to NHV group (22.5 ± 5.49, 14.51 ± 5.02, respectively). HV groups showed the increased diameter of the testicular vein (3.52 ± 0.71) as compared to NHV group (3.42 ± 0.72). Chronic smoking revealed a statistically significant effect on testosterone (P = 0.015) and LH levels (P < 0.041) in the HV group. In addition, hookah smoking sessions per week affect sperm motility (P = 0.02) in the HV group. A significant correlation was observed in sperm count (r = 0.24, P < 0.016) and motility (r = 0.25, P = 0.010) in HV group.

CONCLUSION

Chronic hookah smoking significantly affects the reproductive hormonal and semen parameters in varicocele patients as compared to people with varicocele without smoking. This implies that hookah has an adverse effect on male reproductive and infertility.