Online ISSN: 2515-8260

Keywords : varicocele


COMPARITIVE STUDY ON OPEN AND LAPAROSCOPIC VARICOCELECTOMY IN A TERTIARY CARE CENTRE

DR. D. SREEDHAR REDDY,DR. N. NAGARAJU,DR. GOPIKUMAR,DR. MAMATHA,DR. M. SHYAM KUMAR .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 126-146

INTRODUCTION: Varicocele is defined as an abnormal dilatation and tortuous Pampiniform plexus of veins. Only mode of treatment is surgical correction. Surgical procedure can be performed by open scrotal approach, open inguinal approach microinguinal or subinguinal approach, laparoscopic ligation or embolization of testicular vein by intervention radiologist. Advantages of laparoscopic varicocelectomy includes, safe, increased magnification, facilitating more accurate identification of vessels, lymphatics and the internal spermatic artery. An additional incision can be avoided in bilateral cases. AIM OF THE STUDY: To Compare Laparoscopic Varicocelectomy Versus Open Varicocelectomy. METHODOLOGY: Single centre, prospective observational descriptive study, on 50 patients, in Government General Hospital, Kadapa from December 2019 to December 2021. RESULTLS & CONCLUSION: Varicocele was common in the 3rd and 4th decades and a significant cause of male infertility and common on left side. Laparascopic varicocelectomy is safe and effective procedure when compared to open varicocelectomy with significant reduction in operative time,
European Journal of Molecular & Clinical Medicine
ISSN2515-8260 Volume10, Issue 04,2023
127
minimal post operative complications and decreased hospital stay, increasing the patient satisfaction and comfort towards the procedure. There was no much significant in open and lap surgery over the pre operative and post operative semen parameters

A prospective assessment of the utility of high-resolution ultrasound and color doppler in evaluating the scrotal pathologies

K Sai Shravan Kumar, Dr. Sreekanth Dakaraju Pagadala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 314-320

Aim: To classify (etiologically) and to evaluate various scrotal pathologies using ultrasonography and describe the role of high-resolution ultrasound and colour doppler in their diagnosis and differentiation.
Methods: A prospective study was conducted in the RVM Institute of Medical Sciences & Research Centre, Laxmakkapally, Telangana, India for the period of 1 year. The 100 patients with clinical features of scrotal diseases were include in this study. All the patients included in the study underwent scrotal ultrasonography using 7.0-12.0 MHZ high frequency linear array transducer coupled with Colour Doppler in Esaote My Lab 40 and Phillips affinti 70G equipments.
Results: The patients most commonly involved were those belonging to the age group of 30 to 40 years (38%). The least number of patients belonged to the age group of 0-10 years (4%). On USG, the total number of lesions detected were 120. The most common cause of scrotal pathologies was hydrocele (n=31, 25.83%) followed by epididymal cyst (n=20, 16.67%), epididymo-orchitis (n=16, 13.33%), epididymitis (n=9; 7.5%), funiculitis (n=8, 6.67%), varicocele (n=7, 5.83%), pyocele (n=6, 5%), testicular torsion (n=5, 4.17%), testicular abscess (n=5, 4.17%), inguino-scrotal hernia (n=4, 3.33%), testicular microlithiasis (n=3, 2.5%), testicular tumour (n=3, 2.5%) and tubercular epididymo-orchitis (n=3, 2.5%). The number of scrotal lesions seen on the left side were 45(37.5%), on the right side were 35 (29.17%) and in bilateral locations were 20(16.67%). Associated symptoms included swelling, pain, fever and infertility. Almost all the scrotal pathologies were associated with scrotal swelling (n=97, 97%) except in 3 cases. Epididymal cysts were seen in 20 patients, Acute epididymo-orchitis (n=16) was most commonly seen on the left side. Hydrocele (n=31) was the most common scrotal pathology detected in this study. Varicocele 7 patients was most commonly seen on the left side. Testicular torsion was detected in 5 (n = 5) patients. 3 (n=3, 60%) patients had right testicular torsion.
Conclusion: High frequency ultrasonography with Color Doppler study serves as an excellent diagnostic imaging modality in the evaluation of scrotal diseases. It is the investigation of choice since it is highly sensitive, easy to perform, widely available, repeatable and involves no risk of ionizing radiation. Periodic follow-up USG scans are recommended for patients with inflammatory scrotal lesions to monitor response to treatment and to reveal the development of complications.

Efficacy of different approaches of varicocelectomy for symptomatic varicocele

Y.VKeshav Prasad, A N Bhargava Vyas, Srirama Bhat M, Harish Rao K, Rajat Choudhari .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2591-2596

Introduction: Varicocele is the most common, surgically correctable cause of male infertility. The ideal indication for varicocelectomy is male infertility due to poor semen parameters, but varicocelectomy may also be performed for testicular pain, androgen deficiency, and progressive testicular atrophy and non-obstructive azoospermia. The purpose of the study is check efficacy of different approaches of varicocelectomy on Semen parameters (sperm morphology and sperm counts).
Material and methods:This was an observational study, comparing sperm morphology and sperm counts before and after different approaches of varicocelectomy. Study was conducted in the three hospitals affiliated to a medical college in South India over a period of 2years. A total of 24 cases of varicocele were included in the study. The study results were analysed by Mann-Whitney U test.
Results:Of the observed surgical techniques, the Sub inguinal approach for varicocelectomy was used among 10 (42%) patients followed by inguinal approach in 7 (29%) patients. The mean increase in sperm count was 150% in the subinguinal approach which was higher than all other techniques. The symptomatic relief was similar in all approaches.
Conclusion:Sub inguinal approach of varicocelectomy is better compared to other techniques with respect to sperm counts with good symptomatic relief post operatively.
 

Resistin, Leptin In Human Seminal Plasma: Relationship With TNF-Α And Parameters Semen In Oligozoospermia With And Without Varicocele

Hadi A. Abokallal; Nuha Yaarub Al- Harbi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 4838-4846

Purpose: Varicocele may be associated with normozoospermic or oligozoospermia. Much dispute still exists regarding the diagnosis, management, and pathophysiology of spermatogenesis alterations associated with varicocele. We analyzed the two adipokines and tumor necrosis factor (TNF-α) in the seminal plasma of men with normozoospermic and oligozoospermia with or without varicocele.
Materials and Methods: Where the study performed in the Biology department, College of Science, University of Babylon, and an academic clinic in 70 consecutive patients with varicocele and 35 controls without varicocele. for the period of September 2019 to February 2020. The age of the patients was 21-50 years. The samples were divided according to WHO (2010) into two groups normozoospermia and oligizoospermia. There were 35 patients of men with primary infertility were diagnosed with varicocele and 35 without varicocele divided into four groups as oligozoospermia with varicocele (VO) (no. 13), oligozoospermia without varicocele (CO) (no. 21), and fertile controls as normozoospermic with varicocele (VN) (no.22) and normozoospermic without varicocele (CN) (no. 14)
Results:
Increased seminal resistin and TNF-α (P< 0.05) levels were observed in the of men with varicocele and in those with normozoospermic and oligozoospermia. In this study reported adipokines levels in human seminal plasma in normal weight, overweight, and obese patients. seminal leptin and resistin level in overweight, and obese patients group was significantly higher (P< 0.05) than that in normal weight group, but there was significant difference in the seminal TNF-α levels between these two groups.