Comparison of the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain
7
Citation
37
Reference
10
Related Paper
Citation Trend
Abstract:
We investigated the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain. We retrospectively reviewed the records of patients who underwent varicocelectomy. The age, body mass index, grade, laterality of varicocele, testicular volume difference, time to hospital visit, serum testosterone level and semen parameters were evaluated. A total of 954 patients were included. The painful group had lower mean age, lower BMI, higher grade of varicocele, smaller testicular volume difference and shorter time to hospital visit than the painless group. In addition, the median serum total testosterone level and total sperm count, concentration and motility were higher in the painful group than in the painless group. In multivariate analysis, there were significant differences between the two groups in age, grade of varicocele, testis volume difference, time to hospital visit, total sperm count and concentration. Patients with painful varicocele visited hospital earlier because of the pain and tended to start treatment sooner. They were also younger, had smaller testis atrophy and had higher sperm concentration, even though they had a higher grade of varicocele than patients without pain. Although scrotal pain in varicocele patients is difficult to treat, it leads to early diagnosis and treatment.Keywords:
Testicular atrophy
Scrotal Pain
Testicular pain
Semen Analysis
Testicular volume
Testicular pain
Orchiectomy
Testicular atrophy
Scrotal Pain
Cite
Citations (25)
Testicular torsion is a rare disease that mostly involves children. Peak incidence is in infancy and in adolescence. Testicular torsion is rarely seen in men over 40 years of age and has only once been accompanied with spermatocele. We report the case of a 40-year-old man with testicular pain one day prior to visiting our clinic. The patient's visit to the clinic was delayed due to history of occasional testicular pain related to his bilateral spermatoceles. On arrival, a color Doppler ultrasound test was performed, which revealed heterogeneous echo in the right testis with no vascular flow, suggestive of torsion, as well as two cystic lesions in the right and left scrotums indicating spermatoceles. The patient was immediately transferred to the operating room where the bilateral spermatoceles were resected and after detorting, the right testis was saved. After four months, a normal left testis along with partial right testicular atrophy was observed. It is highly recommended to educate patients with spermatocele who have no indication for surgical treatment to visit their physician in case any new testicular pain is experienced. Furthermore, testicular pain regardless of the co-existing pathology may always be treated as an indicator of suspected torsion.
Testicular pain
Scrotal Pain
Testicular atrophy
Orchiopexy
Color doppler
Cite
Citations (4)
Abstract Objectives: The aim of the present study was to assess and compare pre‐ and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches. Methods: The study included 144 consecutive patients with left‐sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an ‘Assesment Questionnaire for Scrotal Pain’ both before and after the surgery. Results: The surgery was successful in 101 (83.4%) of the 121 patients available for follow up. Seventy‐four (61.1%) patients reported the complete resolution of pain while 27 patients (22.3%) reported partial resolution. Symptoms worsened in a single case and pain persisted postoperatively in 19 cases (15.7%). There were no statistically significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had external spermatic vein ligation and those who did not, regardless of the surgical approach (inguinal or subinguinal). All patients who reported complete or partial resolution of pain stated that they would recommend surgery to relatives with the same problem. Conclusions: Varicocelectomy using either inguinal or subinguinal approaches is an effective and reasonable treatment option in this patient group and should include external spermatic vein ligation for a satisfactory outcome.
Spermatic Vein
Scrotal Pain
Testicular pain
Gold standard (test)
Cite
Citations (60)
Background: Varicocele is the abnormal dilatation of pampiniform venous plexus and internal spermatic vein. It is the commonest surgically correctable cause of male infertility. We reviewed pattern of presentation and management of varicocele in our hospital.Methodology: This is a retrospective review of 100 patients managed for varicocele in our hospital from January 2011 to August, 2020. Data was collected via a proforma and was analyzed using SPSS version 25.0. The results were reported in percentages, mean ± standard deviation.Results: The mean age of the patients was 35.2 ± 8.4 years with a range of 17 to 58 years. The varicocele was asymptomatic in 86 patients (86%), it was during evaluation for infertility. There were symptoms in 16 single young patients. The symptoms include scrotal pain and discomfort in 14 patients (14%) each and scrotal swelling in 7 patients (7%). There were co-morbidities in 7 patients (7%). There were abnormal seminal fluid parameters in 75 patients (75%), low testosterone in 23 patients (23%), testicular atrophy and or primary testicular failure in 51 patients (51%). Open sub-inguinal varicocelectomy was done in 67 patients (67%), 60% as day cases. The overall rate of improvement in seminal fluid parameters and pregnancy rates were 68.6 % and 11.9% respectively. There was resolution of symptoms in all the 16 symptomatic cases. Conclusion: Varicocele is a common cause of infertility in our environment and most patients are discovered during evaluation for infertility. Patients present late with testicular dysfunction with or without primary testicular failure. Varicocelectomy was associated with good symptomatic response, improvement in seminal fluid parameters but low pregnancy rate due to testicular atrophy.
Testicular atrophy
Testicular pain
Presentation (obstetrics)
Cite
Citations (0)
Summary— Paediatric varicocele is a well known entity but its effect on adult infertility has not been adequately clarified. Since measurement of testicular volume is currently the best method of estimating the male reproductive potential, 945 boys aged between 13 and 18 years were examined with regard to testicular volume and the incidence of varicocele. The average volumes for right and left testes were 15.087 ±0.237 and 14.514 ± 0.347 ml respectively, and the incidence of varicocele was 16.7%. The incidence increased from 14.5 to 21.7% as the ages increased from 14 to 18. The differences in volume of the 2 testes in boys with varicocele were statistically significant when compared with the normal group, but this significance failed to become more pronounced when the slight varicocele group (grade I) was included with the normal group and compared with the severe varicocele group (grades II and III). There may be no significant differences between the volumes of the 2 testes in boys with varicocele when careful measurement and strict statistical analyses are applied. However, some boys in the varicocele group were found to have testicular volumes below the confidence interval (mean ‐ SE) or under 1 SD, and the 2 testicular volumes differed in certain age groups. This group requires further follow‐up. The results of this study have added further contradictory findings to the issue of paediatric varicocele in terms of testicular atrophy, estimation of potential fertility and the indications for immediate surgery. There is a need for further prospective controlled trials.
Testicular volume
Testicular atrophy
Cite
Citations (4)
Testicular atrophy
Testicular pain
Cite
Citations (0)
Varicocele is the most common diagnosis in men presenting to fertility clinics. Traditional indications for correction of varicocele include scrotal pain, testicular atrophy, and infertility without other apparent causes. Adolescent varicocele correction is indicated if pain or testicular growth retardation is present. Following varicocelectomy most studies report improved semen parameters, increased serum testosterone, improvement in functional sperm defects, and the return of motile sperm in selected azoospermic men. However, conflicting data exists on pregnancy and fertility outcomes. Consistent data supporting the effectiveness of repairing subclinical varicoceles is sparse. Most authors generally agree that the primary effect of varicoceles is on testicular temperature. Varicoceles are diagnosed primarily by physical examination. Radiographic assessments are helpful when physical examination is inconclusive or when further objective documentation of a patient's condition is necessary. Several surgical approaches to varicocelectomy exist, each with its own advantages and drawbacks. We prefer the inguinal approach to varicocelectomy, except when there is a history of previous inguinal surgery. In such cases, the subinguinal technique is employed. Routine use of an operating microscope and a micro Doppler probe affords easier identification of vessels and lymphatics. Varicocele remains the most surgically treatable form of male infertility. Knowing the correct techniques of diagnosis and surgical correction ensures the best chance of successful outcomes in terms of post-operative morbidity, improved semen parameters, and pregnancy rates.
Testicular atrophy
Subclinical infection
Semen Analysis
Scrotal Pain
Cite
Citations (15)
Objective To determine the prevalence and site of varicocele and varicocele‐related testicular atrophy in children and adolescents. Patients and methods The study included 4052 boys aged of 2–19 years, divided into four age groups; the findings of a physical examination, any testicular atrophy and testicular volume were recorded. Results Varicocele was detected in 293 (7.2%) of the 4052 boys; the prevalence was 0.79% in those aged 2–6 years, 0.96% at 7–10 years, 7.8% at 11–14 years and 14.1% at 15–19 years. The prevalence was 0.92% in 1232 children aged 2–10 years and 11.0% in 2531 adolescents aged 11–19 years ( P < 0.001). The prevalence increased significantly at age 13 years ( P < 0.005). The varicocele was unilateral in 263 of the 293 (89.7%) boys with varicocele; of these, one (0.38%) was on the right and the others on the left side. Varicoceles were bilateral in 30 of 279 boys (10.8%) aged 11–19 years but none were detected in those aged < 11 years. Varicocele‐related testicular atrophy was not present in those aged < 11 years, but seven boys (7.3%) aged 11–14 years and 17 (9.3%) aged 15–19 years had testicular atrophy. The difference in prevalence between the last two age groups with atrophy was not significant. Conclusion These findings support the view that varicocele is a progressive disease and that the prevalence of varicocele and testicular atrophy increases with the puberty.
Testicular atrophy
Testicular volume
Cite
Citations (231)
A total of 40 mature or aged rams with spontaneous varicocele detected by scrotal palpation were subjected to detailed necropsy examination. Varicocele was bilateral in 22 rams or was located on the left or right sides only, in 8 and 10 rams, respectively. This distribution contrasted with varicocele in man in which the left side is involved in 70 to 100% of cases. Mean sizes of varicoceles in mm (length x diameter) were 117 x 46 and 104 x 45 for the left and right sides, respectively, and they were located high in the pampiniform plexus, approximately 100 mm from the dorsal pole of the corresponding testis. All varicoceles were thrombosed. Changes associated with large varicoceles included testicular mineralisation and occluding thrombosis of testicular vessels. Total testis weight-bodyweight ratio in rams with varicocele (5.8 to 6.4 x 10(-3] was significantly less (P less than 0.05) than in normal (control) rams from the same flocks (7.9 x 10(-3] suggesting that some degree of testicular atrophy resulted from presence of a varicocele.
Cite
Citations (11)
We investigated the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain. We retrospectively reviewed the records of patients who underwent varicocelectomy. The age, body mass index, grade, laterality of varicocele, testicular volume difference, time to hospital visit, serum testosterone level and semen parameters were evaluated. A total of 954 patients were included. The painful group had lower mean age, lower BMI, higher grade of varicocele, smaller testicular volume difference and shorter time to hospital visit than the painless group. In addition, the median serum total testosterone level and total sperm count, concentration and motility were higher in the painful group than in the painless group. In multivariate analysis, there were significant differences between the two groups in age, grade of varicocele, testis volume difference, time to hospital visit, total sperm count and concentration. Patients with painful varicocele visited hospital earlier because of the pain and tended to start treatment sooner. They were also younger, had smaller testis atrophy and had higher sperm concentration, even though they had a higher grade of varicocele than patients without pain. Although scrotal pain in varicocele patients is difficult to treat, it leads to early diagnosis and treatment.
Testicular atrophy
Scrotal Pain
Testicular pain
Semen Analysis
Testicular volume
Cite
Citations (7)