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El-Shimi BI, Mohareb RM, Ahmed HH, Abohashem RS, Mahmoud KF, Hanna DH. Mechanistic Insights into Bisphenol A-Mediated Male Infertility: Potential Role of Panax Ginseng Extract. Chem Biodivers 2024:e202400480. [PMID: 38818674 DOI: 10.1002/cbdv.202400480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/01/2024]
Abstract
Male infertility is identified by the inability of a man to successfully impregnate his fertile female partner, even following a year of regular unprotected sexual intercourse. About half of all infertility cases are attributed to what is known as "male factor" infertility. The escalating prevalence of male infertility in the contemporary era across the globe can be largely attributed to environmental pollution, which is the common etiological factor due to the ubiquitous presence of the environmental contaminants. Bisphenol A is recognized as an endocrine-disrupting chemical that has adverse effects on both male and female reproductive systems. On the other hand, numerous studies have demonstrated that Panax ginseng possessed the potential to improve male infertility parameters; promote spermatogenesis, recover the quality and motility of sperm and enhance testicular functions as it acted as a natural androgen supplement. The objective of this review is to offer a summary of the findings obtained from the current research data on the insult of bisphenol A (BPA) on male infertility and its supposed mode of action, as well as shed light on the potent ameliorative role of Panax ginseng extract, with a special focus on the mechanism behind its action. This review delivers a clear understanding of BPA mechanism of action on male infertility and the presumed risks deriving from its exposure. Also, this review provides evidence for the functional role of Panax ginseng extract in restoring male fertility.
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Affiliation(s)
- Basma I El-Shimi
- Chemistry Department, Faculty of Sciences, Cairo University, Giza, Egypt
| | - Rafat M Mohareb
- Chemistry Department, Faculty of Sciences, Cairo University, Giza, Egypt
| | - Hanaa H Ahmed
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
- Stem Cell Lab., Centre of Excellence for Advanced Science, National Research Centre, Dokki, Giza, Egypt
| | - Rehab S Abohashem
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
- Stem Cell Lab., Centre of Excellence for Advanced Science, National Research Centre, Dokki, Giza, Egypt
| | - Khaled F Mahmoud
- Food Technology Department, National Research Centre, Dokki, Giza, Egypt
| | - Demiana H Hanna
- Chemistry Department, Faculty of Sciences, Cairo University, Giza, Egypt
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Okeke CJ, Ojewola RW, Jeje EA, Tijani KH, Ogunjimi MA. A comparison of loupe-assisted and non-loupe-assisted subinguinal varicocelectomy. Niger Postgrad Med J 2023; 30:218-225. [PMID: 37675698 DOI: 10.4103/npmj.npmj_39_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Introduction Varicocele is a treatable aetiology of male infertility. Magnification with surgical loupe has been associated with improved outcome and reduced morbidity than the conventional technique without magnification. Objective To compare the outcomes of two techniques of subinguinal varicocelectomy, with a surgical loupe and without. Patients and Methods This was a prospective randomised hospital-based study. Forty-six patients were randomised to two arms - Group A: loupe-assisted subinguinal varicocelectomy (LASV) and Group B: open subinguinal varicocelectomy without Loupe (OSV). They all had their semen and hormonal parameters compared preoperatively and at 3 and 6 months postoperatively. Post-operative complications were also assessed. P < 0.05 was considered statistically significant. Results The mean age was 38.28 ± 4.55 years with a range of 27-46 years. The mean age in Group A was 37.35 ± 4.68 and 39.22 ± 4.33 years in Group B. There was an improvement in motility, sperm count and concentration in both the groups at 3 and 6 months (P < 0.05). However, there was no difference in these parameters on comparison of the two groups at 3 and 6 months (P > 0.05). Follicle-stimulating hormone decline was significant in the OSV group at 3 and 6 months, P = 0.010 and 0.021, respectively. There was no difference in other hormonal parameters both at 3 and 6 months (P > 0.05). The pregnancy rate in each arm of study was 4.3%. All complications occurred in Group B. Conclusion Both techniques resulted in improvement in seminal fluid parameters. All complications occurred in the arm that had subinguinal varicocelectomy without loupe. Loupe-assisted subinguinal varicocelectomy is safe and effective.
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Affiliation(s)
- Chike John Okeke
- Department of Urology, Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
| | - Rufus Wale Ojewola
- Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
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Phan HT, Nguyen TX, Nguyen DV, Vu HA, Le DA, Pham NH. Efficacy of scroto-inguinal microsurgical varicocelectomy in treating male infertility. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00141-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractBackgroundVaricocele presents as the most frequent cause of infertility in men. Most reports showed that varicocelectomy has a significant impact on male fertility and reproductive outcome. This study aims to evaluate the safety and effectiveness of scrotal–inguinal microsurgical varicocelectomy in treating male infertility.MethodsWe prospectively studied preoperatively and postoperatively (at 3 and 6 months) 86 consecutive patients diagnosed with varicocele, abnormal semen parameters, and infertility, undergoing scrotal–inguinal microsurgical varicocelectomy. Semen test was performed before surgery and at 3 months and 6 months after surgery. The reproductive events were short-term followed up.ResultsThe median age of the patient was 32.9 ± 5.1 (20–43). Two cases (2.7%) had a minor infection of the scrotum incision, who were well treated by appropriate antibiotics. After operation, total sperm count and the percentage of motile sperms at 3 months and 6 months were significantly higher than those pre-varicocelectomy, respectively. In total, 26.7% (23/86) of all couples achieved a spontaneous pregnancy. Late complications such as testicular atrophy, hydroceles, and recurrent varicocele have not occurred.ConclusionsScrotal–inguinal microsurgical varicocelectomy is an acceptable method in treating male infertility due to high rate of reproductive outcomes and very low rate of complications.
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Antonuccio P, Marini HR, Micali A, Romeo C, Granese R, Retto A, Martino A, Benvenga S, Cuzzocrea S, Impellizzeri D, Di Paola R, Fusco R, Cervellione RM, Minutoli L. The Nutraceutical N-Palmitoylethanolamide (PEA) Reveals Widespread Molecular Effects Unmasking New Therapeutic Targets in Murine Varicocele. Nutrients 2021; 13:nu13030734. [PMID: 33668991 PMCID: PMC7996616 DOI: 10.3390/nu13030734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/26/2022] Open
Abstract
Varicocele is an age-related disease with no current medical treatments positively impacting infertility. Toll-like receptor 4 (TLR4) expression is present in normal testis with an involvement in the immunological reactions. The role of peroxisome proliferator-activated receptor-α (PPAR-α), a nuclear receptor, in fertility is still unclear. N-Palmitoylethanolamide (PEA), an emerging nutraceutical compound present in plants and animal foods, is an endogenous PPAR-α agonist with well-demonstrated anti-inflammatory and analgesics characteristics. In this model of mice varicocele, PPAR-α and TLR4 receptors’ roles were investigated through the administration of ultra-micronized PEA (PEA-um). Male wild-type (WT), PPAR-α knockout (KO), and TLR4 KO mice were used. A group underwent sham operation and administration of vehicle or PEA-um (10 mg/kg i.p.) for 21 days. Another group (WT, PPAR-α KO, and TLR4 KO) underwent surgical varicocele and was treated with vehicle or PEA-um (10 mg/kg i.p.) for 21 days. At the end of treatments, all animals were euthanized. Both operated and contralateral testes were processed for histological and morphometric assessment, for PPAR-α, TLR4, occludin, and claudin-11 immunohistochemistry and for PPAR-α, TLR4, transforming growth factor-beta3 (TGF-β3), phospho-extracellular signal-Regulated-Kinase (p-ERK) 1/2, and nucleotide-binding oligomerization domain-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) Western blot analysis. Collectively, our data showed that administration of PEA-um revealed a key role of PPAR-α and TLR4 in varicocele pathophysiology, unmasking new nutraceutical therapeutic targets for future varicocele research and supporting surgical management of male infertility.
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Affiliation(s)
- Pietro Antonuccio
- Department of Human Pathology of Adult and Childhood, University of Messina, 98125 Messina, Italy; (P.A.); (C.R.); (R.G.); (A.R.); (A.M.)
| | - Herbert Ryan Marini
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (H.R.M.); (S.B.); (L.M.)
| | - Antonio Micali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy;
| | - Carmelo Romeo
- Department of Human Pathology of Adult and Childhood, University of Messina, 98125 Messina, Italy; (P.A.); (C.R.); (R.G.); (A.R.); (A.M.)
| | - Roberta Granese
- Department of Human Pathology of Adult and Childhood, University of Messina, 98125 Messina, Italy; (P.A.); (C.R.); (R.G.); (A.R.); (A.M.)
| | - Annalisa Retto
- Department of Human Pathology of Adult and Childhood, University of Messina, 98125 Messina, Italy; (P.A.); (C.R.); (R.G.); (A.R.); (A.M.)
| | - Antonia Martino
- Department of Human Pathology of Adult and Childhood, University of Messina, 98125 Messina, Italy; (P.A.); (C.R.); (R.G.); (A.R.); (A.M.)
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (H.R.M.); (S.B.); (L.M.)
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy; (S.C.); (D.I.); (R.F.)
| | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy; (S.C.); (D.I.); (R.F.)
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy; (S.C.); (D.I.); (R.F.)
- Correspondence: ; Tel.: +39-090-2213655; Fax: +39-090-2213300
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy; (S.C.); (D.I.); (R.F.)
| | | | - Letteria Minutoli
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (H.R.M.); (S.B.); (L.M.)
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Arab D, Doustmohammadi H, Ardestani Zadeh A. Dietary supplements in the management of varicocele-induced infertility: A review of potential mechanisms. Andrologia 2020; 53:e13879. [PMID: 33108825 DOI: 10.1111/and.13879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 12/30/2022] Open
Abstract
Varicocele is a main cause of lower production of spermatozoon and infertility with multiple pathophysiological mechanisms. In the past decades, the use of dietary supplements has significantly increased due to both the modern lifestyle and the food shortages of the industrialised countries. The purpose of this review paper is to collect scientific evidences from basic and clinical studies which support the use of dietary supplements to define the clinical framework for patients with varicocele. In the present review, we used keywords such as dietary supplements, varicocele, male infertility, oxidative stress, DNA fragmentation, sperm parameters to find the proper articles. The standard search biomedical engines were used for seeking the papers. The use of dietary supplements such as minerals, vitamins and antioxidants has an essential role in the prevention and treatment of varicocele by increasing the levels of antioxidant enzymes (e.g. peroxidase, superoxide dismutase and catalase) and decreasing the levels of inflammatory markers (e.g. tumour necrosis factor-α, interleukin-6 and interleukin-1) in testis. According to the results, the dietary supplements may alleviate the spermatogenesis in varicocele patients through different mechanisms such as suppression of stress oxidative and inflammation in testicular tissue.
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Affiliation(s)
- Davood Arab
- Clinical Research Development Center, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran.,Department of Surgery, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Hoda Doustmohammadi
- Department of Anatomy, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Arash Ardestani Zadeh
- Clinical Research Development Center, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran.,Department of Surgery, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
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Abou Ghayda R, El-Doueihi RZ, Lee JY, Bulbul M, Abou Heidar N, Bulbul J, Asmar S, Hong SH, Yang JW, Kronbichler A, Shin JI. Anthropometric Variables as Predictors of Semen Parameters and Fertility Outcomes after Varicocelectomy. J Clin Med 2020; 9:jcm9041160. [PMID: 32325696 PMCID: PMC7230912 DOI: 10.3390/jcm9041160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/16/2022] Open
Abstract
Varicocele is the most common correctable male infertility factor and varicocelectomy has been a mainstay in the management of infertility. However, the role of varicocelectomy as a treatment option has been controversial, and the scientific debate around it is still ongoing. Our study aimed to explore the role of anthropometric variables of infertile patients and their relation to sperm parameters following varicocelectomy. The outcome of 124 infertile patients who underwent open sub-inguinal varicocelectomy by a single surgeon over the last ten years was studied. Post varicocelectomy, four semen parameters (volume, total count, motility, and morphology) were analyzed and adjusted according to anthropometric variables including age, varicocele grade, and body mass index (BMI) of patients. Total count and motility were significantly improved after surgery. Varicocelectomy improved semen parameters, notably the count and the motility, especially in younger patients, lower grades of varicocele patients, and low BMI patients. In addition, BMI was positively correlated with volume in pre-varicocelectomy and post-varicocelectomy.
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Affiliation(s)
- Ramy Abou Ghayda
- Division of Urology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA;
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Robert Zakhia El-Doueihi
- Division of Urology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (R.Z.E.-D.); (M.B.); (N.A.H.)
| | - Jun Young Lee
- Department of Nephrology, Yonsei University, Wonju College of Medicine, Wonju Kangwon 26426, Korea; (J.Y.L.); (J.W.Y.)
| | - Muhammad Bulbul
- Division of Urology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (R.Z.E.-D.); (M.B.); (N.A.H.)
| | - Nassib Abou Heidar
- Division of Urology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (R.Z.E.-D.); (M.B.); (N.A.H.)
| | - Jad Bulbul
- Department of Radiology, Loyola University Medical Center, 2160 South 1st Avenue, Maywood, IL 60153, USA;
| | - Samer Asmar
- Surgery Department, Post-Doctoral Research Fellow at University of Arizona, Tucson, AZ 85721, USA;
| | - Sung Hwi Hong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Jae Won Yang
- Department of Nephrology, Yonsei University, Wonju College of Medicine, Wonju Kangwon 26426, Korea; (J.Y.L.); (J.W.Y.)
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-228-2050
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Lara-Cerrillo S, Gual-Frau J, Benet J, Abad C, Prats J, Amengual MJ, Ribas-Maynou J, García-Peiró A. Microsurgical varicocelectomy effect on sperm telomere length, DNA fragmentation and seminal parameters. HUM FERTIL 2020; 25:135-141. [PMID: 31916507 DOI: 10.1080/14647273.2019.1711204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Varicocele is one of the main causes of male infertility and microsurgical varicocelectomy (MV) seems to be the best procedure for its repair and to reduce testicular oxidative stress (ROS). As ROS causes guanine modifications, we postulated that DNA damage could be more intense in telomeres due to their G-rich nature. We studied the effect of MV on sperm telomere length (TL), single- and double-strand DNA fragmentation (ssSDF and dsSDF) and seminal parameters. Sperm telomeres from 12 fertile donors and 20 varicocele patients before and nine months after MV were labelled using FITC-PNA qFISH (a new method to obtain absolute TL from relative fluorescence intensity using FITC-fluorescent spheres). Both ssSDF and dsSDF were analysed using the alkaline and neutral Comet assays, respectively. The results showed that varicocele and MV had no effect on TL. Seminal parameters, ssSDF and dsSDF of varicocele patients were altered. Although these parameters improved after MV, values did not reach those seen in fertile donors. A good estimation of absolute TL was developed based on FITC-fluorescent spheres. The results showed that TL is not affected by varicocele or surgery. However, MV is able to partially reduce altered seminal parameters, ssSDF and dsSDF values in varicocele patients.
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Affiliation(s)
| | - Josep Gual-Frau
- Servei d'Urologia, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Jordi Benet
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Carlos Abad
- Servei d'Urologia, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Juan Prats
- Servei d'Urologia, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Spain
| | - María José Amengual
- Centre Diagnòstic UDIAT, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí - UAB, Sabadell, Spain
| | - Jordi Ribas-Maynou
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Effect of royal jelly on testicular antioxidant enzymes activity, MDA level and spermatogenesis in rat experimental Varicocele model. Tissue Cell 2019; 57:70-77. [DOI: 10.1016/j.tice.2019.02.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 12/18/2022]
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Al-Mohammady AA, El-Sherbiny AF, Mehaney AB, Ghobara YA. Varicocele repair in patients prepared for intracytoplasmic sperm injection: To do or not to do? Andrologia 2018; 51:e13185. [PMID: 30375021 DOI: 10.1111/and.13185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/25/2018] [Accepted: 09/30/2018] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study sought to evaluate the impact of varicocele repair on intracytoplasmic sperm injection outcomes. PATIENTS AND METHODS A prospective comparative study was conducted at the Assisted Reproduction Unit, International Islamic Center for Population Studies and Researches, Al-Azhar University. This study included 100 non-azoospermic infertile men with a history of varicocele who were scheduled for intracytoplasmic sperm injection, half of them had already undergone prior subinguinal varicocelectomy at least 12 months prior to ICSI without clinically evident recurrence (treated group 1), and the other half has any grade of an unrepaired clinical varicocele (untreated group 2) at sperm injection. All cases were clinically evaluated and eligible for analysis by using inclusion and exclusion criteria. ICSI outcomes compared between the two groups, including fertilisation rate, embryo development rate and pregnancy outcome. RESULTS Our study did not show any significant difference between treated and untreated groups regarding the mean values of fertilisation (0.7759 ± 0.2708 vs. 0.7119 ± 0.3057, p = 0.2708), embryo development (0.7759 ± 0.2708 vs. 0.6991 ± 0.3211, p = 0.1990) or different embryo grades. There was no statistically significant difference between groups regarding pregnancy occurrence rates (p = 0.0928). CONCLUSION Infertile men scheduled for ICSI do not seem to benefit from varicocele repair as regard to the outcomes of ICSI.
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Affiliation(s)
- Abdelshakour A Al-Mohammady
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed F El-Sherbiny
- Department of Andrology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt
| | - Amira B Mehaney
- Department of Embryology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt
| | - Yasser A Ghobara
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Shafi H, Delavar MA. THE IMPACT OF LOUPE-ASSISTED INGUINAL VARICOCELECTOMY ON SEMEN QUALITY AND PREGNANCY RATE. ACTA ENDOCRINOLOGICA-BUCHAREST 2018; 14:252-254. [PMID: 31149266 DOI: 10.4183/aeb.2018.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Open varicocelectomy is generally performed without microscopic equipment in Iran. We report our experience with loupe-assisted inguinal varicocelectomy, and its impact on semen parameters and pregnancy rate. Subjects and Methods We conducted a retrospective interventional study on secondary data obtained from the medical records of 303 men with varicoceles, who underwent an inguinal varicocelectomy between March 2003 and April 2012. The surgical technique involved the use of a 3.0 × loupe during spermatic cord dissection at the level of the internal inguinal ring under spinal anesthesia. Semen samples were analyzed for sperm concentration, motility, and sperm morphology before the varicocelectomy and after 3 months. All the infertile patients were followed-up postoperatively for more than 1 year. Results There were 9 (3.0%) varicocele recurrences and 3 (1.0%) hydroceles. After varicocelectomy, sperm concentration and motile spermatozoa increased. In addition, spermatozoa with normal morphology improved significantly postoperatively. Of the 303 subjects treated, 153 (83.2) had a 1-year preoperative history of infertility; the spontaneous pregnancy rate of the spouses during the follow-up period was reported to be 61.4%. Conclusions The results of this research indicated that varicocelectomy using loupe-assisted inguinal technique could improve semen parameters and pregnancy rate with a low postoperative complication rate.
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Affiliation(s)
- H Shafi
- Babol University of Medical Sciences, Infertility and Reproductive Health Research Center, Department of Urology, Babol, Iran
| | - M A Delavar
- Babol University of Medical Sciences, Infertility and Reproductive Health Research Center, Department of Midwifery, Babol, Iran
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Cui WS, Shin YS, You JH, Doo AR, Soni KK, Park JK. Efficacy and safety of 0.75% ropivacaine instillation into subinguinal wound in patients after bilateral microsurgical varicocelectomy: a bi-center, randomized, double-blind, placebo-controlled trial. J Pain Res 2017; 10:1515-1519. [PMID: 28740417 PMCID: PMC5505161 DOI: 10.2147/jpr.s131692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy. Patients and methods Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins. Before repairing external oblique aponeurosis, 6 mL of 0.75% ropivacaine and 6 mL of normal saline were instilled under the fascia and around the funiculus (spermatic cord) by a randomized and double-blind method. Visual analog scale (VAS) pain score and Prince Henry Pain Score (PHPS) were used for evaluating operative sites at 1, 2, 4, and 8 hours and 7 days after surgery. Safety and tolerability were evaluated throughout the course of this study by assessing adverse events. Results A total of 55 men completed the study. Of these 55 men, 31 received instillation of ropivacaine on the left operative site, while 24 received instillation of ropivacaine on the right operative site. VAS pain scores and PHPS in the ropivacaine-instilled operative site were significantly lower compared to those obtained with placebo at 2, 4, and 8 hours after surgery. In general, instillation of ropivacaine was safe and well tolerated in patients. Conclusion Ropivacaine instillation into inguinal surgical site wound significantly reduced postoperative pain after microsurgical varicocelectomy.
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Affiliation(s)
- Wan Shou Cui
- Andrology Center, Peking University First Hospital, Beijing, People's Republic of China
| | - Yu Seob Shin
- Department of Urology, Armed Forces Capital Hospital, Seongnam.,Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju
| | - Jae Hyung You
- Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju
| | - A Ram Doo
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Kiran Kumar Soni
- Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju
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Jin X, Man C, Gong D, Fan Y. Adjuvant Treatment with Qilin Pill for Men with Oligoasthenospermia: A Meta-Analysis of Randomized Controlled Trials. Phytother Res 2017. [PMID: 28635070 DOI: 10.1002/ptr.5854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Qilin pill has been used in the management of oligoasthenospermia. This meta-analysis aimed to evaluate the effects of Qilin pill as an adjunctive therapy on semen parameters in oligoasthenospermic men. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Wanfang, CNKI, and VIP databases until June 2016. Randomized controlled trials (RCTs) that evaluated Qilin pill as an adjunctive therapy in oligoasthenospermic were included. Dichotomous data and continuous data were calculated as the risk ratio (RR) and mean difference (MD) with their 95% confidence interval (CI), respectively. Eight RCTs involving 778 patients were identified. Adjunctive treatment with Qilin pill significantly improved the semen volume (MD 0.50 mL; 95% CI 0.42-0.59), sperm concentration (MD 5.01 × 106 /mL; 95% CI 3.28-6.75), sperm motility (MD 7.54%; 95% CI 5.64-9.45), grade A sperm (MD 9.75%; 95% CI 4.05-15.45), serum testosterone level (MD 1.66 nM; 95% CI 0.40-2.92), and pregnancy rate (RR 1.46; 95% CI 1.08-1.99) during follow-up. However, differences in the serum follicle-stimulating and luteinizing hormone levels were not significant. Adjunctive treatment with Qilin pill significantly improves the sperm quality in patients with oligoasthenospermia. However, further trials are necessary to investigate the efficacy of Qilin pill on oligoasthenospermia-induced male infertility. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xin Jin
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Changfeng Man
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Dandan Gong
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
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Naz M, Kamal M. Classification, causes, diagnosis and treatment of male infertility: a review. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s13596-017-0269-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Choe JH, Seo JT. Is Varicocelectomy Useful for Subfertile Men with Isolated Teratozoospermia? Urology 2015; 86:1123-8. [PMID: 26341572 DOI: 10.1016/j.urology.2015.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/13/2015] [Accepted: 08/18/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the effect of microsurgical varicocelectomy on sperm morphology in subfertile men with isolated teratozoospermia and a clinically palpable varicocele. MATERIALS AND METHODS A retrospective review was performed of men with isolated teratozoospermia who had undergone microsurgical varicocelectomy. Semen analyses following varicocelectomy were performed at 2- to 3-month intervals. Responders to the varicocelectomy were defined as those who fulfilled the following criteria in semen analysis: (1) an improvement in percentage of normal forms to ≥4% and (2) normal results for all other semen parameters. RESULTS A total of 80 patients underwent unilateral varicocelectomy (n = 49) or bilateral varicocelectomy (n = 31) (mean age of 36 ± 0.4 years, range 24-44). After a mean postoperative follow-up period of 6.8 months, the mean percentage of normal sperm forms increased from 0.9% to 3.5% (P < .001), and the mean sperm motility improved from 50.5% to 56.6% (P = .004). The number of responders to the surgery was 16 (20%), and their mean percentage of normal forms increased from 1.3% to 9.1%. The mean preoperative and postoperative semen volume and sperm concentration were not different (P > .05). No differences were observed in age, current smoking status, body mass index, or grade of varicocele between responders and nonresponders. CONCLUSION Varicocelectomy might be an option for treating subfertile patients with isolated teratozoospermia and a clinically apparent varicocele. However, patients should be advised that the surgery helps in limited patients only because more patients did not benefit from the surgery.
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Affiliation(s)
- Jin Ho Choe
- Department of Urology, Cheil General Hospital, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Ju Tae Seo
- Department of Urology, Cheil General Hospital, Dankook University College of Medicine, Seoul, Republic of Korea.
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15
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Samal S, Swain SK, Pallavee P, Ghose S. Lymphangiocele: A very rare cause of primary infertility. J Hum Reprod Sci 2015; 8:52-3. [PMID: 25838750 PMCID: PMC4381384 DOI: 10.4103/0974-1208.153129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/04/2015] [Accepted: 02/27/2015] [Indexed: 11/13/2022] Open
Abstract
There are limited causes of surgically treatable male infertility. Lymphangiocele of scrotum is a very rare condition particularly in adult life. Lymphangiocele causing infertility is further rare and not reported in English literature so far. We report an extremely rare case of lymphangiocele in a 29 years male presenting with male infertility that improved after surgery.
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Affiliation(s)
- Sunita Samal
- Department of Obstetrics and Gynecology, MGMC and RI, Puducherry, India
| | | | - P Pallavee
- Department of Obstetrics and Gynecology, MGMC and RI, Puducherry, India
| | - Seetesh Ghose
- Department of Obstetrics and Gynecology, MGMC and RI, Puducherry, India
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16
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Gordhan CG, Sadeghi-Nejad H. Scrotal pain: evaluation and management. Korean J Urol 2015; 56:3-11. [PMID: 25598931 PMCID: PMC4294852 DOI: 10.4111/kju.2015.56.1.3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/04/2014] [Indexed: 11/18/2022] Open
Abstract
Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.
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Affiliation(s)
- Chirag G Gordhan
- Division of Urology, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Hossein Sadeghi-Nejad
- Division of Urology, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
- Center for Male Reproductive Medicine & Microsurgery, Hackensack University Medical Center, Hackensack, NJ, USA
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