Andrologia最新文献

{"title":"Reduced Libido Is a Major Factor in Decreased Erectile Function among Men with Mild COVID-19","authors":"Peng Yang,&nbsp;Tianle Zhu,&nbsp;Yukuai Ma,&nbsp;Rui Gao,&nbsp;Pan Gao,&nbsp;Xi Liu,&nbsp;Jingjing Gao,&nbsp;Hui Jiang,&nbsp;Xiansheng Zhang","doi":"10.1155/2023/3923033","DOIUrl":"10.1155/2023/3923033","url":null,"abstract":"<div>\u0000 <p>During the Corona Virus Disease-2019 (COVID-19) pandemic, among men infected with SARS-CoV-2, little attention has been given to reduced libido and its associations with decreased erectile function, even though there may be physical and psychological factors that contribute to the two. So the purpose of the study is to determine the correlation between decreased erectile function and reduced libido in SARS-CoV-2 infected people during the COVID-19 pandemic and to describe the associated clinical, psychic, and lifestyle parameters. We recruited 321 eligible men with SARS-CoV-2 infection in the urology clinic of our hospital. We used the International Index of Erectile Function-5 (IIEF-5), the Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7) module, and Pittsburgh Sleep Quality Index to independently evaluate the subjects, collect relevant data, and analyze the data. In this study, we show that both libido and erectile function were decreased after SARS-CoV-2 infection (<i>p</i> &lt; 0.0001), and reduced libido was strongly correlated with decreased erectile function (<i>p</i> &lt; 0.0001; odds ratio (OR) = 11.33). In addition, anxiety (OR = 2.41, CI = 1.13–5.23), (<i>p</i> &lt; 0.05), symptomatic infection (OR = 3.293, CI = 1.11–11.48), (<i>p</i> &lt; 0.05), and body mass index (OR = 0.88, CI = 0.83–0.92), (<i>p</i> &lt; 0.05) were also associated with decreased erectile function. So, we think that during the COVID-19 pandemic, for erectile dysfunction patients who decreased erectile function after SARS-CoV-2 infection, we should not only pay attention to patients’ erectile function status but also to patients’ reduced libido status.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3923033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI Model Developed Using Machine Learning for Predicting Sperm Retrieval in Micro-TESE for Nonobstructive Azoospermia Patients","authors":"Hideyuki Kobayashi,&nbsp;Masato Uetani,&nbsp;Fumito Yamabe,&nbsp;Yozo Mitsui,&nbsp;Koichi Nakajima,&nbsp;Koichi Nagao","doi":"10.1155/2023/5693116","DOIUrl":"10.1155/2023/5693116","url":null,"abstract":"<div>\u0000 <p>Azoospermia is a severe problem that prevents couples from having their own children through natural pregnancy. In nonobstructive azoospermia (NOA), microdissection testicular sperm extraction (micro-TESE) is required to collect sperm and, at 40%–60%, the sperm retrieval success rate is not very high. Previous studies identified no single clinical finding or investigation that could accurately predict the outcome of sperm retrieval. It would be very valuable to have a factor for predicting the possibility of sperm retrieval in patients with NOA before performing micro-TESE. We retrospectively obtained data from the medical records of 430 patients who underwent micro-TESE from 2011 to 2020. Parameters extracted were age, height, body weight, body mass index, luteal hormone, follicle-stimulating hormone, PRL, total testosterone, E2, T/E2, sperm retrieval, G-band, AZF, medical history, Rt testis, and Lt testis. Prediction One, which does not require coding, was used to create the AI prediction model for sperm retrieval. Prediction One makes the best prediction model using an artificial neural network with internal cross-validation. Prediction One also evaluates the “importance of variables” using a method based on permutation feature importance. The AUC for the AI model was 0.7246, which is acceptable. In addition, among the variables, T/E2 ratios contributed most to predicting whether sperm retrieval was possible or not. However, the difference in T/E2 between successful and unsuccessful sperm retrieval was not statistically significant. In addition, our analysis of data from 20 patients who underwent micro-TESE in 2021 found that in 85%, the actual result matched the result predicted using our novel AI model. We created an AI model for predicting sperm retrieval in patients with NOA before undergoing micro-TESE. In addition, we found that T/E2 ratios contributed most to predicting possibility of sperm retrieval in NOA using machine learning.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5693116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Consequence of Short Insemination Strategy on Sperm Biological Characteristics, Embryo Morphokinetics, and Clinical Outcomes in the IVF Program","authors":"Fatemeh Anbari,&nbsp;Mohammad Ali Khalili,&nbsp;Maryam Mahaldashtian,&nbsp;Azam Agha-Rahimi,&nbsp;Ali Nabi,&nbsp;Mahin Izadi,&nbsp;Bryan Woodward,&nbsp;Esmat Mangoli","doi":"10.1155/2023/5566061","DOIUrl":"10.1155/2023/5566061","url":null,"abstract":"<div>\u0000 <p>Overnight coincubation of the cumulus–oocyte complexes (COCs) with spermatozoa may be accompanied by overproduction of reactive oxygen species (ROS) and possible determinant effects on sperm cellular status in the in vitro fertilization (IVF) program. The COCs from 100 cases were divided into two groups of short (2 hr) and long (18 hr) inseminations. The malondialdehyde (MDA) level as by-product of ROS was assessed in the insemination medium. The sperm DNA integrity, the mitochondrial membrane potential (MMP), and acrosome reaction (AR) were evaluated using sperm chromatin dispersion (SCD), fluorescence stain of JC-1, and double staining, respectively. Normally, fertilized oocytes (<i>n</i> = 525) were assessed via time-lapse monitoring (TLM) for assessment of the time of fading (tPNF), 2 until 8 timing (t2-t8), s1 (t2-tPNF), s2 (t4-t3), s3 (t8-t5), and duration of cell cycles. Finally, the best embryos were transferred, and clinical outcomes were assessed. Higher rates of MDA concentration, DNA fragmentation, and AR and low rate of MMP were noticed in long compared to short insemination groups (<i>p</i> ≤ 0.0001). The morphokinetic parameters showed five-cell stage (t5) and cell cycle 3 (cc3) that were significantly different between the groups (<i>p</i> = 0.04 and <i>p</i> = 0.03, respectively). A high level of ROS observed in the long insemination group might have a detrimental effect on sperm status. Although, similar embryo quality and clinical outcomes were noticed in two insemination groups, but the trend was toward the short insemination.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5566061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vitro Coexposure of Silymarin with Lithium Chloride Preserves Human Sperm Quality: A Useful Approach to Reduce Oxidative Damages","authors":"Zahra Nasimi,&nbsp;Hamid Reza Momeni,&nbsp;Tahereh Etemadi,&nbsp;Niloufar Darbandi","doi":"10.1155/2023/8838280","DOIUrl":"10.1155/2023/8838280","url":null,"abstract":"<div>\u0000 <p>Lithium, a common component in various mood-stabilizing drugs, induces adverse effects on spermatozoa and human fertility. Oxidative stress, as a possible mechanism involved in lithium toxicity, can be reversed using antioxidants. Therefore, in this study, the effects of silymarin as a potent antioxidant were evaluated on human spermatozoa treated with lithium. Human spermatozoa were divided into five groups: (1) spermatozoa at 0 min, (2) spermatozoa at 180 min (control group), (3) spermatozoa treated with lithium chloride (500 <i>μ</i>M) for 180 min, (4) spermatozoa were treated with silymarin (100 <i>μ</i>M) + lithium chloride (500 <i>μ</i>M) for 180 min, and (5) spermatozoa treated with silymarin (100 <i>μ</i>M) for 180 min. Sperm motility and viability, the levels of malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP), and the activity of antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase) were evaluated in these groups. The results showed that sperm motility and viability significantly (<i>p</i>  &lt; 0.001) decreased in the group treated with lithium. In addition, a significant increase (<i>p</i>  &lt; 0.001) was observed in MDA levels, while FRAP amount and the activity of antioxidant enzymes decreased significantly (<i>p</i>  &lt; 0.001) in this group. Interestingly, these results were significantly (<i>p</i>  &lt; 0.001) reversed in the group treated with silymarin + lithium. The finding of the present study showed that oxidative stress plays a crucial role in lithium toxicity in human spermatozoa, and the coapplication of silymarin as a potent antioxidant with lithium can protect human sperm against oxidative stress-induced damage.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8838280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139232913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curcumin Attenuates Ferroptosis and Ameliorates Erectile Function in Diabetic Rats by Activating Nrf2/HO-1 Pathway","authors":"Yuehui Jiang,&nbsp;Siyan Xing,&nbsp;Dawei Ni,&nbsp;Baibing Yang,&nbsp;Jun Kai,&nbsp;Tong Wang,&nbsp;Wen Yu,&nbsp;Yutian Dai","doi":"10.1155/2023/7236816","DOIUrl":"10.1155/2023/7236816","url":null,"abstract":"<div>\u0000 <p>Previous studies have shown that curcumin has a therapeutic effect on diabetic erectile dysfunction (ED), but the exact mechanism of action remains unclear. In order to ascertain the involvement of ferroptosis in diabetic ED and explore the underlying mechanism by which curcumin mitigates ferroptosis in penile endothelial cells under conditions of high-glucose stimulation, we conducted an investigation utilizing a rat model of diabetes induced by a high-fat diet and streptozotocin injection. The 40 male Sprague–Dawley rats were randomly divided into four groups: blank control, diabetes control, ferroptosis inhibitor treatment, and curcumin treatment. After 8 weeks, the erectile function of all rats was evaluated through electrical stimulation of the cavernous nerve. Histological and molecular changes of the cavernous body were analyzed using western blot and immunohistochemistry. Penile endothelial cells were then treated with appropriate concentrations of high glucose and curcumin to explore the mechanism of nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling in curcumin’s ability to alleviate ferroptosis in endothelial cells stimulated by high glucose. According to research, diabetic rats experience a decrease in erectile function, damaged endothelial cells, and ferroptosis in tissues. However, curcumin treatment has been shown to be effective in improving erectile function and related tissue and molecular changes in diabetic rats. Furthermore, in vitro experiments have confirmed that curcumin can inhibit the occurrence of ferroptosis in penile endothelial cells that are stimulated by high glucose through Nrf2/HO-1 signaling. Curcumin has been found to improve the occurrence of penile ED in diabetic penile endothelial cells. This is achieved by inhibiting the level of ferroptosis, and the mechanism behind this improvement may be linked to the upregulation of the expression level of Nrf2/HO-1.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7236816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactive Blue 2 Labels Protamine in Late-Haploid Spermatids and Spermatozoa and Can Be Used for Toxicity Evaluation","authors":"Satoshi Yokota,&nbsp;Tomohiko Wakayama,&nbsp;Hidenobu Miyaso,&nbsp;Kousuke Suga,&nbsp;Masakatsu Fujinoki,&nbsp;Satoru Kaneko,&nbsp;Satoshi Kitajima","doi":"10.1155/2023/7364862","DOIUrl":"10.1155/2023/7364862","url":null,"abstract":"<div>\u0000 <p>Reactive blue 2 (RB2) dye specifically binds to the nuclei of human spermatozoa under weakly alkaline conditions, thereby providing a new method for assessing sperm quality. However, this technique has not yet been applied to other mammalian species, such as well-established rodent models, which would allow evaluation of the male reproductive toxicity of new drug candidates in nonclinical studies. We aimed to evaluate the usefulness of RB2 staining in assessing testicular and epididymal sperm toxicity in mice using a busulfan-induced infertility model. Male C57BL/6J mice were intraperitoneally administered 40 mg/kg of busulfan. After 28 days, the testes and epididymis were collected and stained with RB2 at pH 10. In vitro evaluations were conducted on uncoated glass slides with RB2 mixed with mouse synthetic protamines, protamines extracted from the human spermatozoa or intracellular protein components from somatic cells without protamines. Following peanut agglutinin lectin histochemistry, RB2-positive cells were observed in elongating and elongated spermatids at all stages except for stages IX–XI of the seminiferous epithelium. After busulfan administration, the proportion of RB2-positive germ cells in the seminiferous tubules was significantly decreased, and no RB2-positive spermatozoa were found in the caput epididymis of treated mice. Aggregates were observed in a mixture of RB2 dye (pH 10) and protamines but not in a mixture of intracellular protein components without protamines, and this specificity was lost at a neutral pH. Our study demonstrated that RB2 specifically stains steps 12–16 spermatids, indicating specific binding to the protamines expressed in these spermatids. The RB2 staining technique has potential as a biomarker for male reproductive toxicity, allowing for the rapid visualization of protamination in an animal model commonly used for the evaluation of male reproductive toxicity.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7364862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135042454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial–Temporal Characteristics of Semen Quality in Infertile Men in Wenzhou, China during 2010–2018","authors":"Xuchao Dai,&nbsp;Mengqi Zhang,&nbsp;Gang Chen,&nbsp;Chengshuang Pan,&nbsp;Jiujia Zheng,&nbsp;Qianjin Fei,&nbsp;Hong Huang,&nbsp;Zhigang Wu","doi":"10.1155/2023/7416033","DOIUrl":"10.1155/2023/7416033","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Declining semen quality has become one of the most serious public health problems worldwide; however, the spatial–temporal characteristics of semen quality of infertile men remain unknown. <i>Objective</i>. To explore spatial–temporal characteristics of semen quality of infertile men in Wenzhou from 2010 to 2018 and thereby provide a scientific basis for development of strategies to enhance male reproductive health. <i>Methods</i>. We obtained 22,978 semen sample data from 2010 to 2018 from the Reproductive Medicine Center and Urology of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, China. Linear regression analyses and spatial autocorrelation analyses were used to study spatial–temporal characteristics of semen quality parameters. <i>Results</i>. Overall, from 2010 to 2018, mean values for total sperm number and semen volume showed linear increasing trends, and mean values for total sperm motility showed linear decreasing trend (all <i>P</i> &lt; 0.05). Cold spot analyses of progressive sperm motility, total sperm motility, and normal sperm forms were also in main urban area of Wenzhou (Lucheng District, Ouhai District, Longwan District, and Dongtou District) and hot spot were also in nonmain urban area of Wenzhou (mainly including Taishun County, Pingyang County, and Wencheng County). However, hot spot analyses of total sperm number and semen volume were mainly in Dongtou District. <i>Conclusions</i>. The main urban area is the “harder-hit area” of semen quality, while for the islands area is the “high-withdrawal area.” Government departments need to pay more attention to improve male reproductive health in the main urban areas and actively control the potential influencing factors of male reproductive health, such as occupational exposure and life stress. Good environmental quality and plenty of seafood intake may be beneficial to semen quality.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7416033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135241020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nose Size Predicts Adult Erectile Penile Length","authors":"Chunlu Xu,&nbsp;Tao Song,&nbsp;Yutian Dai,&nbsp;Guohai Sun","doi":"10.1155/2023/6636816","DOIUrl":"10.1155/2023/6636816","url":null,"abstract":"<div>\u0000 <p>Previous studies have proved that nose size has a positive correlation with stretched penile length but stretched penile length does not fully represent erectile penile length. It is considered that the formation and growing ability of the penis is determined by the action of androgen in the fetal period and nose size has also been determined to some extent before birth. If the nose size is indeed related to the length of the penis, there must be a common mechanism behind it. To further confirm the relationship between nose size and penile length, especially erectile penile length, a correlation analysis was carried out by collecting general data and the data related to the nose, ears, and genitals of 377 males aged 20–56 years, including erectile penile length and erectile penile circumference. The results revealed that nose size had the highest correlation with erectile penile length (<i>r</i> = 0.507, <i>p</i> = 0) and flaccid penile length (<i>r</i> = 0.451, <i>p</i> = 0). Therefore, it is believed that nose size is an independent predictor of flaccid and erectile penile length, and the common factors that contribute to this correlation may appear in the fetal period.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6636816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of TAPP Combined with Biological Mesh on Reproductive Function in Male Inguinal Hernia Patients of Reproductive Age: A Single-Center Retrospective Study","authors":"Li-Xiao Zhang,&nbsp;Jia-Qi Kang,&nbsp;Zhi-Bin Ye,&nbsp;Li-Fei Zhang,&nbsp;Hong-Yu Zhao,&nbsp;Jiang-Nan Ge,&nbsp;Wei Liang","doi":"10.1155/2023/5009982","DOIUrl":"10.1155/2023/5009982","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To explore the effect of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) combined with biological mesh on the reproductive function of male inguinal hernia patients during the reproductive period. <i>Methods</i>. Sixty male inguinal hernia patients during the reproductive period admitted to our department from October 2015 to October 2021 were selected for retrospective analysis. All patients were treated with TAPP combined with biological mesh by the same team. Bilateral testicular volume, testicular temperature, testicular blood perfusion, peripheral serum testosterone concentration, and semen analysis were examined before surgery, 3 months after surgery, 6 months after surgery, and 12 months after surgery. <i>Results</i>. The preoperative testicular volume, temperature, and blood perfusion were compared between the healthy side and the affected side; the testicular volume, temperature, blood perfusion of the affected side, peripheral blood testosterone concentration, and semen analysis were compared among the four time points, which were before operation, 3 months after operation, 6 months after operation, and 12 months after operation. All <i>p</i> values were &gt;0.05. <i>Conclusions</i>. The presence of inguinal hernia had no significant effect on the volume and blood perfusion of male testis. In addition, TAPP combined with biological mesh has no negative effect on postoperative reproductive function of male inguinal hernia patients of childbearing age, which manifested as a safe and feasible surgical method.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5009982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between Microsurgical Varicocelectomy with and without Testicular Delivery for Treatment of Varicocele: An Updated Systematic Review and Meta-Analysis","authors":"Yulong Wang,&nbsp;Yuxuan Song,&nbsp;Caipeng Qin,&nbsp;Chunlong Zhang,&nbsp;Yiqing Du,&nbsp;Tao Xu","doi":"10.1155/2023/7348578","DOIUrl":"10.1155/2023/7348578","url":null,"abstract":"<div>\u0000 <p>Dilated testicular gubernacular veins after varicocelectomy were reported to be the cause of varicocele recurrence. The gubernacular veins start at the tail of the testicular and merges into the posterior scrotal veins. The gubernacular veins could be ligated only after testicular delivery (TD) anatomically. TD and ligation of the gubernacular veins during microsurgical varicocelectomy might reduce the varicocele recurrence but this method is still under debate. Therefore, we performed this systematic review and meta-analysis and assessed varicocele recurrence, complications as well as clinical outcomes after microsurgical varicocelectomy with TD. Relevant researches were searched on the PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure databases to perform an updated meta-analysis. Standardized mean differences, relative risks (RRs), and their 95% confidence intervals (CIs) were applied to evaluate result indicators. This updated meta-analysis included 17 publications with 10 randomized controlled trials and 7 cohort studies. A total of 2,254 participants, including 1,024 subjects with TD and 1,230 without TD, were involved. The pooled results demonstrated that microsurgical varicocelectomy with TD might lead to higher incidences of postoperative scrotal edema (RR = 4.20, 95% CI = 2.60–6.81, <i>p</i> &lt; 0.001), testicular hydrocele (RR = 6.58, 95% CI = 1.19–36.20, <i>p</i> = 0.030), and orchiepididymitis (RR = 6.33, 95% CI = 2.08–19.31, <i>p</i> = 0.001) than the group without TD. Similar findings were also found in subgroup analysis of varicocele grade II and III. By contrast, we failed to find significant differences between them in semen parameters, varicocele recurrence, serum testosterone, and natural pregnancy (<i>p</i> &gt; 0.05). Sensitivity analysis revealed the pooled results were stable and no publication bias was detected. TD during microsurgical varicocelectomy may lead to more postoperative complications and may not be beneficial for semen parameters, recurrence of varicocele, and natural pregnancy. Therefore, varicocele patients may not benefit more from TD.</p>\u0000 </div>","PeriodicalId":7817,"journal":{"name":"Andrologia","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7348578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136023043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}