Browsing by Subject "varicocelectomy"

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    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.
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    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.