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Alan B Retik - One of the best experts on this subject based on the ideXlab platform.
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relationship of varicocele grade and testicular Hypotrophy to semen parameters in adolescents
The Journal of Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose: Surgical indications for correcting adolescent varicocele include high varicocele grade and testicular Hypotrophy. To our knowledge these findings have not been correlated with semen parameters to date. We examined the relationship between unilateral left varicocele grade or the testicular volume differential and semen parameters in adolescents.Materials and Methods: Semen analyses were done in 57 Tanner stage V adolescent males at ages 14 to 20 years (mean±SD 18 ± 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Data analysis was performed using nonparametric statistical methods.Results: Boys with testicular volume differentials greater than 10% vs those with differentials less than 10% had significantly lower sperm concentration and total motile sperm counts. For differentials greater than 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys wi...
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relationship of varicocele grade and testicular Hypotrophy
Journal of Pediatric Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose Surgical indications for correcting adolescent varicocele have included high varicocele grade and testicular Hypotrophy. To date, these findings have not been correlated with semen parameters. The objective of our study was to examine the relationship between unilateral, left varicocele grade or testicular volume differential and semen parameters in adolescents. Material and methods Semen analyses were obtained in 57 Tanner Stage V adolescent males, ages 14 to 20 years (mean = 18, SD = 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Analysis of the data was performed using nonparametric statistical methods. Results Boys with testicular volume differentials >10% versus those with differentials 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys with volume differentials >20% versus those in the 20% volume differential category, 59% had very low total motile sperm counts ( Conclusions Sonographically derived volume differentials >10% between normal and affected testes correlate with significantly decreased sperm concentration and total motile sperm count. This finding may serve as a marker to identify those adolescents with unilateral, left varicocele at greatest risk for future infertility. At the very least, a semen analysis and close annual follow-up of these adolescents seems warranted.
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testicular Hypotrophy does not correlate with grade of adolescent varicocele
The Journal of Urology, 2005Co-Authors: Joseph P Alukal, David Zurakowski, Anthony Atala, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, James Mandell, Craig A Peters, Harriet J Paltiel, Alan B RetikAbstract:ABSTRACTPurpose: Testicular Hypotrophy is the most widely accepted indication for correcting adolescent varicocele. Previous studies in adolescents have shown a relationship between increasing grade of varicocele and the likelihood of testicular Hypotrophy. As this relationship has significant clinical implications, we studied the correlation between grade and testicular volume disproportion in our adolescent varicocele population.Materials and Methods: We reviewed the adolescent varicocele database at our institution. A total of 168 patients 8 to 21 years old were studied. We routinely calculated testis volumes using scrotal ultrasound. Testicular disproportion was calculated using the equation [(size of unaffected testis) − (size of affected testis)]/(size of unaffected testis) × 100%. Disproportion was categorized as less than 10%, 10% to 20% and more than 20%. Varicoceles were graded by an attending urologist with the patient standing, using the system of Dubin and Amelar. Analysis of variance and Pea...
Marc Goldstein - One of the best experts on this subject based on the ideXlab platform.
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microsurgical varicocelectomy a review
Asian Journal of Andrology, 2013Co-Authors: Akanksha Mehta, Marc GoldsteinAbstract:Varicocelectomy is the most commonly performed surgical procedure for the treatment of male infertility. Although several different techniques for varicocele repair have been described in the literature, microsurgical varicocelectomy performed through a subinguinal or inguinal incision is recognized as the gold-standard approach for varicocelectomy, due to high success rates with minimal complications. Standard indications for varicocelectomy include palpable varicocele(s), with one or more abnormal semen parameters, and, for the couple trying to conceive, in the setting of normal or correctable female infertility. However, varicocele repair is often recommended and undertaken for reasons other than infertility, including low serum testosterone, testicular pain, testicular Hypotrophy and poor sperm DNA quality. This article reviews the technical aspects of microsurgical varicocelectomy, and its indications in adults and adolescents.
Raimondo M Cervellione - One of the best experts on this subject based on the ideXlab platform.
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testicular volume and semen parameters in patients aged 12 to 17 years with idiopathic varicocele
Journal of Pediatric Surgery, 2012Co-Authors: David J B Keene, Yasmin Sajad, George Rakoczy, Raimondo M CervellioneAbstract:Abstract Purpose Varicocele is potentially a progressive condition that may affect fertility. The authors have encouraged sperm banking for their postpubertal patients with varicocele and aim to evaluate the sperm parameters in this cohort of patients. Methods With institutional ethical approval, sperm variables (volume, concentration, and forward motility) of patients with postpubertal varicocele who opted for sperm banking were prospectively recorded. The following parameters were also acquired: (a) ultrasound measurement of testicular volume, (b) clinical grade, and (c) venous Doppler. Patients were divided into 2 groups: symmetrical testis (group A) and asymmetrical testis (group B). Testicular asymmetry was defined as greater than 20% difference in testicular volume compared with contralateral testis. Sperm parameters were compared between groups A and B using Mann-Whitney U test and P Results Fifteen patients were included: 10 in group A and 5 in group B. Median semen concentration in group B was significantly lower than group A (3 vs 26 million/mL; P = .04). One hundred percent of group B failed World Health Organisation adult criteria for normal spermiograms compared with 50% of group A. Conclusions Sperm concentration and quality was lower in patients with asymmetrical testis. Testicular dysfunction may be present before the onset of testicular Hypotrophy. When testicular Hypotrophy is present, testicular dysfunction is very likely.
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varicocele in adolescents a 6 year longitudinal and followup observational study
The Journal of Urology, 2008Co-Authors: Nicola Zampieri, Raimondo M CervellioneAbstract:Purpose: Through a school screening program for varicocele we studied the prognostic value of hemodynamic vs clinical grading for predicting the risk of progression, time to worsening and the final outcome in adolescents with varicocele.Materials and Methods: A school screening program was set up for boys between ages 10 and 16 years to assess pubertal development, varicocele, testicular vein reflux and testicular volume. Those who eventually had ipsilateral testicular Hypotrophy underwent surgery. All patients underwent semen analysis after age 18 years. Varicocele grade was correlated with pubertal development, testicular vein reflux and semen quality in all groups, whether treated or untreated.Results: A total of 2,107 boys were screened, of whom 609 had a varicocele. By the end of the study 92 patients (15.1%) had undergone surgery. Hypotrophy correlated with spontaneous testicular vein reflux (high grade) in all cases. Semen analysis showed abnormal results in 36% treated and 20% untreated patients.C...
Stuart B Bauer - One of the best experts on this subject based on the ideXlab platform.
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varicocele surgery a decade s experience at a children s hospital
BJUI, 2009Co-Authors: David A Diamond, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, James Mandell, Craig A Peters, Ilina Rosoklija, Jiang Xuewu, Marc Cendron, David ZurakowskiAbstract:OBJECTIVES To review our experience at a children's hospital over a 10-year period with the Palomo, Ivanissevich, subinguinal and laparoscopic techniques for varicocele, assessing the success and complication rates according to specific procedure, and the added effect that the modifications of microsurgery and artery-sparing has had on these rates. A second objective was to assess the rate of testicular compensatory growth after surgery for testicular Hypotrophy. PATIENTS AND METHODS Ninety-two patients with >1 year of follow-up between 1996 and 2006 were assessed retrospectively. The median (range) age at surgery was 15 (8-21) years. Patients were stratified based on the surgical technique used by eight different urology faculty members. Microsurgery and attempted artery-sparing were applied to some Palomo, Ivannisevich, and subinguinal cases but not to laparoscopic procedures. RESULTS The laparoscopic (100%) and Palomo (93%) techniques had significantly higher success rates than the Ivanissevich approach (69%). The success rate with the subinguinal technique (88%) was intermediate between the more successful supra-inguinal and less successful inguinal approaches. There was a higher hydrocele rate (32%) in the laparoscopic approach. Artery sparing significantly lowered hydrocele rates but had no effect on success rates. Incorporating microsurgery also had no effect on success rates but resulted in no hydrocele formation. One case of testicular atrophy occurred in a patient undergoing microsurgical artery-sparing subinguinal spermatic vein ligation. There was compensatory growth in 68% of patients operated on for testicular Hypotrophy. CONCLUSIONS During our 10-year experience the laparoscopic and Palomo approaches were the most successful. The subinguinal approach (usually incorporating microsurgery and artery sparing) had an intermediate success rate. The Ivanissevich approach was least successful. Hydroceles did not occur when microsurgery was used, and were significantly less common with artery sparing. The only case of testicular atrophy was with a microsurgical artery-sparing subinguinal approach. When the spermatic vein was ligated for testicular Hypotrophy there was compensatory growth in two-thirds of testes.
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relationship of varicocele grade and testicular Hypotrophy to semen parameters in adolescents
The Journal of Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose: Surgical indications for correcting adolescent varicocele include high varicocele grade and testicular Hypotrophy. To our knowledge these findings have not been correlated with semen parameters to date. We examined the relationship between unilateral left varicocele grade or the testicular volume differential and semen parameters in adolescents.Materials and Methods: Semen analyses were done in 57 Tanner stage V adolescent males at ages 14 to 20 years (mean±SD 18 ± 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Data analysis was performed using nonparametric statistical methods.Results: Boys with testicular volume differentials greater than 10% vs those with differentials less than 10% had significantly lower sperm concentration and total motile sperm counts. For differentials greater than 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys wi...
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relationship of varicocele grade and testicular Hypotrophy
Journal of Pediatric Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose Surgical indications for correcting adolescent varicocele have included high varicocele grade and testicular Hypotrophy. To date, these findings have not been correlated with semen parameters. The objective of our study was to examine the relationship between unilateral, left varicocele grade or testicular volume differential and semen parameters in adolescents. Material and methods Semen analyses were obtained in 57 Tanner Stage V adolescent males, ages 14 to 20 years (mean = 18, SD = 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Analysis of the data was performed using nonparametric statistical methods. Results Boys with testicular volume differentials >10% versus those with differentials 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys with volume differentials >20% versus those in the 20% volume differential category, 59% had very low total motile sperm counts ( Conclusions Sonographically derived volume differentials >10% between normal and affected testes correlate with significantly decreased sperm concentration and total motile sperm count. This finding may serve as a marker to identify those adolescents with unilateral, left varicocele at greatest risk for future infertility. At the very least, a semen analysis and close annual follow-up of these adolescents seems warranted.
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testicular Hypotrophy does not correlate with grade of adolescent varicocele
The Journal of Urology, 2005Co-Authors: Joseph P Alukal, David Zurakowski, Anthony Atala, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, James Mandell, Craig A Peters, Harriet J Paltiel, Alan B RetikAbstract:ABSTRACTPurpose: Testicular Hypotrophy is the most widely accepted indication for correcting adolescent varicocele. Previous studies in adolescents have shown a relationship between increasing grade of varicocele and the likelihood of testicular Hypotrophy. As this relationship has significant clinical implications, we studied the correlation between grade and testicular volume disproportion in our adolescent varicocele population.Materials and Methods: We reviewed the adolescent varicocele database at our institution. A total of 168 patients 8 to 21 years old were studied. We routinely calculated testis volumes using scrotal ultrasound. Testicular disproportion was calculated using the equation [(size of unaffected testis) − (size of affected testis)]/(size of unaffected testis) × 100%. Disproportion was categorized as less than 10%, 10% to 20% and more than 20%. Varicoceles were graded by an attending urologist with the patient standing, using the system of Dubin and Amelar. Analysis of variance and Pea...
Bartley G Cilento - One of the best experts on this subject based on the ideXlab platform.
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varicocele surgery a decade s experience at a children s hospital
BJUI, 2009Co-Authors: David A Diamond, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, James Mandell, Craig A Peters, Ilina Rosoklija, Jiang Xuewu, Marc Cendron, David ZurakowskiAbstract:OBJECTIVES To review our experience at a children's hospital over a 10-year period with the Palomo, Ivanissevich, subinguinal and laparoscopic techniques for varicocele, assessing the success and complication rates according to specific procedure, and the added effect that the modifications of microsurgery and artery-sparing has had on these rates. A second objective was to assess the rate of testicular compensatory growth after surgery for testicular Hypotrophy. PATIENTS AND METHODS Ninety-two patients with >1 year of follow-up between 1996 and 2006 were assessed retrospectively. The median (range) age at surgery was 15 (8-21) years. Patients were stratified based on the surgical technique used by eight different urology faculty members. Microsurgery and attempted artery-sparing were applied to some Palomo, Ivannisevich, and subinguinal cases but not to laparoscopic procedures. RESULTS The laparoscopic (100%) and Palomo (93%) techniques had significantly higher success rates than the Ivanissevich approach (69%). The success rate with the subinguinal technique (88%) was intermediate between the more successful supra-inguinal and less successful inguinal approaches. There was a higher hydrocele rate (32%) in the laparoscopic approach. Artery sparing significantly lowered hydrocele rates but had no effect on success rates. Incorporating microsurgery also had no effect on success rates but resulted in no hydrocele formation. One case of testicular atrophy occurred in a patient undergoing microsurgical artery-sparing subinguinal spermatic vein ligation. There was compensatory growth in 68% of patients operated on for testicular Hypotrophy. CONCLUSIONS During our 10-year experience the laparoscopic and Palomo approaches were the most successful. The subinguinal approach (usually incorporating microsurgery and artery sparing) had an intermediate success rate. The Ivanissevich approach was least successful. Hydroceles did not occur when microsurgery was used, and were significantly less common with artery sparing. The only case of testicular atrophy was with a microsurgical artery-sparing subinguinal approach. When the spermatic vein was ligated for testicular Hypotrophy there was compensatory growth in two-thirds of testes.
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relationship of varicocele grade and testicular Hypotrophy to semen parameters in adolescents
The Journal of Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose: Surgical indications for correcting adolescent varicocele include high varicocele grade and testicular Hypotrophy. To our knowledge these findings have not been correlated with semen parameters to date. We examined the relationship between unilateral left varicocele grade or the testicular volume differential and semen parameters in adolescents.Materials and Methods: Semen analyses were done in 57 Tanner stage V adolescent males at ages 14 to 20 years (mean±SD 18 ± 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Data analysis was performed using nonparametric statistical methods.Results: Boys with testicular volume differentials greater than 10% vs those with differentials less than 10% had significantly lower sperm concentration and total motile sperm counts. For differentials greater than 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys wi...
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relationship of varicocele grade and testicular Hypotrophy
Journal of Pediatric Urology, 2007Co-Authors: David A Diamond, David Zurakowski, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, Craig A Peters, Harriet J Paltiel, Ilina Rosoklija, Alan B RetikAbstract:Purpose Surgical indications for correcting adolescent varicocele have included high varicocele grade and testicular Hypotrophy. To date, these findings have not been correlated with semen parameters. The objective of our study was to examine the relationship between unilateral, left varicocele grade or testicular volume differential and semen parameters in adolescents. Material and methods Semen analyses were obtained in 57 Tanner Stage V adolescent males, ages 14 to 20 years (mean = 18, SD = 1.6). Varicocele grade was determined by the attending urologist. Testicular volumes were determined by scrotal ultrasound performed by an attending sonologist. Analysis of the data was performed using nonparametric statistical methods. Results Boys with testicular volume differentials >10% versus those with differentials 20% these decreases were more dramatic. Percent motile sperm was significantly lower for boys with volume differentials >20% versus those in the 20% volume differential category, 59% had very low total motile sperm counts ( Conclusions Sonographically derived volume differentials >10% between normal and affected testes correlate with significantly decreased sperm concentration and total motile sperm count. This finding may serve as a marker to identify those adolescents with unilateral, left varicocele at greatest risk for future infertility. At the very least, a semen analysis and close annual follow-up of these adolescents seems warranted.
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testicular Hypotrophy does not correlate with grade of adolescent varicocele
The Journal of Urology, 2005Co-Authors: Joseph P Alukal, David Zurakowski, Anthony Atala, Stuart B Bauer, Joseph G Borer, Bartley G Cilento, James Mandell, Craig A Peters, Harriet J Paltiel, Alan B RetikAbstract:ABSTRACTPurpose: Testicular Hypotrophy is the most widely accepted indication for correcting adolescent varicocele. Previous studies in adolescents have shown a relationship between increasing grade of varicocele and the likelihood of testicular Hypotrophy. As this relationship has significant clinical implications, we studied the correlation between grade and testicular volume disproportion in our adolescent varicocele population.Materials and Methods: We reviewed the adolescent varicocele database at our institution. A total of 168 patients 8 to 21 years old were studied. We routinely calculated testis volumes using scrotal ultrasound. Testicular disproportion was calculated using the equation [(size of unaffected testis) − (size of affected testis)]/(size of unaffected testis) × 100%. Disproportion was categorized as less than 10%, 10% to 20% and more than 20%. Varicoceles were graded by an attending urologist with the patient standing, using the system of Dubin and Amelar. Analysis of variance and Pea...