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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Testicular or epididymal infections (orchitis or epididymitis) both cause painful inflammation and swelling within the ipsilateral scrotal sac, which should be visible to thermography. Varicocele is essentially a varicose vein within the scrotum. These usually painless varicosities appear warmer than the surrounding tissue in a serpentine pattern, similar to varicosities over other body locations (Figure 10.72).182 Non-painful, chronic scrotal swelling that appears cool thermographically may be due to a hydrocele.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The patient has a right-sided varicocele. Varicoceles are more common on the left due to the drainage of the left testicular vein into the left renal vein. The right testicular vein drains directly into the lower pressure inferior vena cava. If a varicocele is just on the right side, then ultrasound of the abdomen, to focus on the retroperitoneal structures, should be performed to ensure there is not an underlying pathology, such as a mass, impeding venous return. If ultrasound cannot be confidently used to assess this, for example in patients with a high body mass index, then other modalities could be considered. Treatment for uncomplicated varicoceles include surgical ligation or embolisation.
Varicocele
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Taha Abo-Almagd Abdel-Meguid Hamoda
A varicocele is defined as an abnormally dilated and tortuous scrotal pampiniform plexus of veins. It has long been recognized that varicocele can cause progressive testicular deterioration, and it has been linked to impaired testicular functions and male infertility. In the early study of MacLeod in 1965 [1], he reported impairments of sperm count, motility, and morphology in men with varicoceles. Similar observations were documented in more recent studies as well [2–4]. Surgical repair of varicoceles has been reported to halt the testicular and sperm damage and to improve the male fertility potential [2–5].
Effect of systemic isotretinoin therapy on semen parameters
Published in Annals of Medicine, 2023
Abdullah Gurel, Gulhan Gurel, Fatma Fırat, Esra Ozgul, Irem Nur Durusu Turkoglu, Tugce Aladag, Ibrahim Baran Duran, Burhan Baylan
Infertility affects 15% of the global population [22], and occurs in both males and females. While 50% of infertility cases are due to both male and female factors, a solely male factor accounts for 25% of cases [23]. Varicoceles are regarded as the primary and correctable cause of male infertility, although 45–60% of men with varicoceles have normal spermiogram values. It is believed that OS induced by varicoceles leads to a deterioration in sperm parameters [19]. Similarly, OS and OFRs are believed to be harmful to sperm, and account for 30–80% of subfertility cases [24]. Hurtado de Catalfo et al. have reported OS products in the semen sample and blood of men with varicoceles to be higher than in those without varicoceles, and these values returned to normal after varicocelectomy [25]. A reduction was identified in OFRs in semen samples collected from men with varicoceles after the administration of isotretinoin [20].
Seminal inflammasome activity in the adult varicocele
Published in Human Fertility, 2022
Mariana Camargo, Emad Ibrahim, Paula Intasqui, Larissa B. Belardin, Mariana P. Antoniassi, Charles M. Lynne, Nancy L. Brackett, Ricardo P. Bertolla
Varicocele is defined as an abnormal venous dilation of the pampiniform plexus with blood reflux (Brugh et al., 2003). Due to its prevalence of 15% in the general male adult population, and up to 80% in men with secondary infertility (Gorelick & Goldstein, 1993; Witt & Lipshultz, 1993), varicocele has been suggested to cause a progressive decline of fertility (Evers & Collins, 2003). Despite many hypotheses regarding the detrimental effect of varicocele on testicular function, inflammation is not usually studied in these men. Varicocele is a vascular disease with many hypotheses described in the literature that may explain its pathophysiology, such as blood reflux and the accumulation of adrenal metabolites in the spermatic vein (Masson & Brannigan, 2014). Metabolites present can be toxic to testicular function, leading to an inflammatory state and seminal oxidative stress (Benoff et al., 2009).
Should the current guidelines for the treatment of varicoceles in infertile men be re-evaluated?
Published in Human Fertility, 2021
Sylvia Yan, Maj Shabbir, Tet Yap, Sheryl Homa, Jonathan Ramsay, Kevin McEleny, Suks Minhas
Varicoceles are diagnosed during physical examination with the patient in the standing and supine positions. This allows for detection of clinically significant varicoceles, which are classified according to the Dubin and Amelar varicocele grading system outlined in Table 1 (Belay, Huang, Shen, & Ko, 2016). Clinically significant varicoceles are defined as grade I, II or III. Varicoceles are palpable or visible on standing with or without the Valsalva manoeuvre. Subclinical varicoceles are identified radiologically, although their role in the aetiopathogenesis of male factor infertility is controversial and they are not currently considered clinically significant according to the current European Association of Urology (EAU) guidelines and other authors (Belay et al., 2016; Jungwirth et al., 2016). The dynamic sonographic findings of varicoceles are commonly classified by the Sartechi and Dubin classification (Belay et al., 2016).