Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .
Expression of the HSPA2 gene in ejaculated spermatozoa from adolescents with and without varicocele.
OBJECTIVE To evaluate mRNA expression of the HSPA2 gene in ejaculated spermatozoa in adolescents with and without varicocele . DESIGN Controlled prospect i ve study . SETTING Patients in an academic research environment . PATIENTS Adolescent patients with clinical diagnosed bilateral varicocele grade s II and III , and adolescent patients without varicocele . INTERVENTION Reverse-transcription-polymerase chain reaction ( RT-PCR ) analysis of HSPA2 gene expression in adolescents with and without varicocele . MAIN OUTCOME MEASURE Comparative RT-PCR expression analysis of HSPA2 gene mRNA , compared to the housekeeping beta-actin gene . RESULTS Sperm from adolescents with varicocele and oligozoospermia had significantly lower levels of HSPA2 gene expression than both adolescents without varicocele ( controls ) and adolescents with varicocele and normal sperm concentration ( P<.05 ) . The latter group had a nonsignificant increase in gene expression compared to the control group . CONCLUSIONS This is the first report on HSPA2 gene expression in ejaculated spermatozoa from adolescents and its relationship with varicocele pathology . Results demonstrated that HSPA2 expression was down-regulated in adolescents with varicocele and oligozoospermia compared to controls . There was a higher , albeit nonsignificant , gene expression in adolescents with varicocele and normal sperm concentration than in controls . We speculate that expression levels of this gene might be used as a molecular marker for the acquisition of thermal tolerance in ejaculated spermatozoa
Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .