Browsing by Subject "Varicocele"
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Item Effect of varicocele on testicular artery blood flow in men: Color doppler investigation(2003) Tarhan S.; Gümüs B.; Gündüz I.; Ayyildiz V.; Göktan C.Objective: Varicocele can be defined as an abnormal tortuosity and dilatation of the veins of the pampiniform plexus. Contradictory results have been obtained from experimental animal models and a few clinical human studies on testicular arterial blood flow in varicocele. The purpose of this study was to determine the changes in testicular arterial blood flow parameters in patients with varicocele. Material and Methods: A total of 62 patients with a clinical diagnosis of left varicocele and a scrotal vein with a diameter of ≥3 mm on color Doppler ultrasonography were included in the study. A total of 44 fertile normal male volunteers served as controls. Results: Median testicular arterial blood flow and median flow rate in milliliters per minute per 100 g of testicular tissue were found to be significantly decreased in the patient group compared to the control group: blood flow, 1.42 and 2.00 ml/min; flow rate, 9.63 and 12.35 ml/min/100 g, respectively (p < 0.05). Positive correlations were found between sperm concentration and left testicular artery blood flow (p < 0.05) and between left testicular volume and testicular artery blood flow (p < 0.05). Conclusions: Testicular arterial blood flow was found to be significantly decreased in men with varicocele. This may be a reflection of the impaired microcirculation. Following decreased testicular arterial blood flow, impaired spermatogenesis may result from defective energy metabolism in the microcirculatory bed.Item Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome(2007) Unlu M.; Orguc S.; Serter S.; Pekindil G.; Pabuscu Y.Objective. To investigate the anatomic and hemodynamic properties of testicular venous drainage and its effects on varicocele formation and reflux using color Doppler ultrasound (US) with emphasis on renal vein entrapment syndrome. Material and methods. Upper abdominal and scrotal US examinations of 35 varicocele patients and 35 healthy male subjects were performed in the supine position during rest, during a Valsalva maneuver and in the erect position. The aortomesenteric angle and distance (AMA and AMD, respectively), peak mean velocities (PVs) and diameters of different segments of renal veins, testicular vein diameters and duration of flow inversion were measured. Results. In the varicocele group, the lateral segment of the left renal vein (LRV) had a larger diameter and slower PV, and the medial segment of the LRV had a smaller diameter and faster PV. The diameter of the dominant draining vein correlated with the PV of the medial and lateral segments of the LRV, whereas there was no correlation between the diameter of the dominant draining vein and the diameters of the right renal vein (RRV) and the lateral segment of the LRV or the PV of the RRV. The duration of flow inversion correlated with the diameter and PV of the medial segment of the LRV. No correlation between the diameters and PVs of the RRV and the lateral segment of the LRV was detected. Conclusions. The decreases in the AMA, AMD, diameter of the medial segment of the LRV and PV of the lateral segment of the LRV, and the increases in the PV of the medial segment of the LRV and the diameter of the lateral segment of the LRV in varicocele patients in all positions suggest the entrapment or impingement of the left renal vein between the aorta and the superior mesenteric artery. This has been defined as the "nutcracker phenomenon", which is known to affect varicocele formation. © 2007 Taylor & Francis.Item Long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow(2011) Tarhan S.; Ucer O.; Sahin M.O.; Gumus B.We aimed to investigate the long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow using color Doppler sonography (CDS) in this observational study. A total of 30 patients clinically diagnosed with left varicocele who underwent a microsurgical inguinal varicocelectomy were examined 3 times with CDS for testicular blood flow parameters, first before, then 3 months after, and finally 6 months after the operation. CDS values of testicular blood flow (peak systolic velocity, end diastolic velocity, resistive index, and pulsatility index) were measured from testicular, capsular, and intratesticular arteries. We also evaluated preoperative and postoperative semen parameters. The mean values of blood flow velocities in the left testicular artery (peak systolic and end diastolic) increased and resistance indices (resistive and pulsatility) in the left capsular and intratesticular arteries decreased significantly after surgery (P < .05). No significant difference was detected between the preoperative and postoperative blood flow parameters in the right testicular, capsular, or intratesticular arteries (P < .05). In the semen analysis run 3 months after the operations, statistically significant increases were found in sperm concentration (P < .001), morphology percentage (P < .001), and total motile sperm concentration (P = .009). The increase in blood flow velocity in the testicular artery and the decrease in resistive and pulsatility indices in the capsular and intratesticular branches of the artery may be strong indicators of an increase in testicular arterial blood flow into the testicular tissue. Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after microsurgical inguinal varicocelectomy. Copyright © American Society of Andrology.Item The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy(Saudi Arabian Armed Forces Hospital, 2016) Ömür D.; Oğuzalp H.; Kiraz H.A.; Ekin S.; Alan C.; Ersay A.R.; Hancı V.Objectives: To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. Methods: This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded. Results: Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was lower (7.7 ± 4.0) versus 21.6 ± 12.4 mg, p<0.001) in the 24 hours after surgery. Conclusion: As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls. © 2016, Saudi Arabian Armed Forces Hospital. All rights reserved.Item The Relationship of Testicular Sonoelastography with Gonadotropin Hormone Levels and Sperm Parameters(Wolters Kluwer Medknow Publications, 2023) Bozkurt Y.; Gumus B.; Ozbay M.; Duzgun F.; Taneli F.; Kurutep S.Background: Elastography is a non-invasive medical imaging technique that helps determine the stiffness of organs and other structures in our body. In this study, we investigated the effectiveness of elastography in the diagnosis of infertility. Aim: In this study, we aimed to examine the relationship between testicular elastography and hormonal parameters and sperm parameters. Patients and Methods: The study included 136 patients, 272 testicles were examined, and the mean age of the study participants was 30.1 years. Testicular tissue stiffness was measured by scrotal ultrasonographic shear wave elastography. Gonadotropin and testosterone hormones were measured from blood samples. Spermiogram parameters were studied manually. Results: The control group included 66 patients, and the varicocele group consisted of 70 patients. Testicular stiffness degrees of the control group were measured as 4.29 kPa for the right testis and 4.23 kPa for the left testis. The varicocele group was divided into grades 1, 2, and 3 according to physical examination. In group 1 (grade 1), the right testis was 4.07 ± 1.24 kPa and the left testis was 3.77 ± 0.98 kPa. In group 2 (grade 2), the right testis was 4.31 ± 1.40 kPa and the left testis was 3.98 ± 0.93 kPa. In group 3 (grade 3), the right testis was 4.73 ± 1.50 kPa and the left testis was 3.99 ± 1.68 kPa. Hormone and sperm parameters were not statistically significant when comparing the control and varicocele groups. There was no statistical significance between the testicular tissue stiffness degrees of the control and varicocele groups. Hormone and spermiogram findings were also similar in groups. Conclusion: It is known that varicocele leads to histological tissue changes in the testes. These changes result in tissue softness and loss while affecting sperm parameters and testosterone levels in a negative way. Before varicocele surgery, there is a need for new imaging methods with more sensitivity that can detect tissue changes in the testes. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.