Testicular Arterial Blood Flow Research Articles

Long-Term Effect of Microsurgical Inguinal Varicocelectomy on Testicular Blood Flow

We aimed to investigate the long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow using color Doppler sonography (CDS) in this observational study. A total of 30 patients clinically diagnosed with left varicocele who underwent a microsurgical inguinal varicocelectomy were examined 3 times with CDS for testicular blood flow parameters, first before, then 3 months after, and finally 6 months after the operation. CDS values of testicular blood flow (peak systolic velocity, end diastolic velocity, resistive index, and pulsatility index) were measured from testicular, capsular, and intratesticular arteries. We also evaluated preoperative and postoperative semen parameters. The mean values of blood flow velocities in the left testicular artery (peak systolic and end diastolic) increased and resistance indices (resistive and pulsatility) in the left capsular and intratesticular arteries decreased significantly after surgery (P < .05). No significant difference was detected between the preoperative and postoperative blood flow parameters in the right testicular, capsular, or intratesticular arteries (P < .05). In the semen analysis run 3 months after the operations, statistically significant increases were found in sperm concentration (P < .001), morphology percentage (P < .001), and total motile sperm concentration (P = .009). The increase in blood flow velocity in the testicular artery and the decrease in resistive and pulsatility indices in the capsular and intratesticular branches of the artery may be strong indicators of an increase in testicular arterial blood flow into the testicular tissue. Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after microsurgical inguinal varicocelectomy.

Impact of slit and nonslit mesh technique on testicular perfusion and volume in the early and late postoperative period of the totally extraperitoneal preperitoneal technique in patients with inguinal hernia

Aims Using slit and nonslit mesh in laparoscopic totally extraperitoneal preperitoneal (TEPP) inguinal hernia repair are well-known approaches. The aim of this prospective, randomized, clinical study was to assess testicular perfusion after these procedures. Methods In the study period, 40 male patients with unilateral inguinal hernia were assigned into 2 equal groups as follows: slit (S) and nonslit (NS). TEPP hernia repair was performed in all patients. In the 2 groups, testicular arterial blood flow and testis volumes were measured by Doppler ultrasonography preoperatively, on the 5th postoperative day, and 6 months postoperatively, respectively. Results No statistically significant difference was found between the preoperative, 5th day postoperatively, and 6-month arterial resistance index (ARI) results when comparing the S and NS groups in ultrasonographic testicular blood flow studies. There was no statistically significant difference of testicular volume between the preoperative period, the 5th postoperative day, and 6 months postoperatively in the 2 groups. Conclusions According to the results, no statistically significant difference was found in terms of testicular perfusion and volume between those 2 methods of TEPP repair for inguinal hernia.

1566: Testicular Arterial Blood Flow as a Marker of Spermatogenesis

You have accessJournal of UrologyDiscussed Poster, Tuesday, May 11, 2004, 1:00 - 5:00 pm1 Apr 20041566: Testicular Arterial Blood Flow as a Marker of Spermatogenesis Stephen J. Gordon, Stuart Campbell, and Vinod H. Nargund Stephen J. GordonStephen J. Gordon More articles by this author , Stuart CampbellStuart Campbell More articles by this author , and Vinod H. NargundVinod H. Nargund More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38774-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1566: Testicular Arterial Blood Flow as a Marker of Spermatogenesis." The Journal of Urology, 171(4S), p. 413 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 413 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Stephen J. Gordon More articles by this author Stuart Campbell More articles by this author Vinod H. Nargund More articles by this author Expand All Advertisement Loading ...

Effect of varicocele on testicular artery blood flow in men--color Doppler investigation.

Varicocele can be defined as an abnormal tortuosity and dilatation of the veins of the pampiniform plexus. Contradictory results have been obtained from experimental animal models and a few clinical human studies on testicular arterial blood flow in varicocele. The purpose of this study was to determine the changes in testicular arterial blood flow parameters in patients with varicocele. A total of 62 patients with a clinical diagnosis of left varicocele and a scrotal vein with a diameter of > or = 3 mm on color Doppler ultrasonography were included in the study. A total of 44 fertile normal male volunteers served as controls. Median testicular arterial blood flow and median flow rate in milliliters per minute per 100 g of testicular tissue were found to be significantly decreased in the patient group compared to the control group: blood flow, 1.42 and 2.00 ml/min; flow rate, 9.63 and 12.35 ml/min/100 g, respectively (p < 0.05). Positive correlations were found between sperm concentration and left testicular artery blood flow (p < 0.05) and between left testicular volume and testicular artery blood flow (p < 0.05). Testicular arterial blood flow was found to be significantly decreased in men with varicocele. This may be a reflection of the impaired microcirculation. Following decreased testicular arterial blood flow, impaired spermatogenesis may result from defective energy metabolism in the microcirculatory bed.

Color doppler sonography of the male genital tract

Color Doppler sonography (CDS) of the male genital tract includes imaging of the prostate gland, of the cavernosal arteries and of the scrotum. It represents a unique means of significantly increasing the predictive positive value of hypoechoic nodules originating in the peripheral zone. In patients with a normal DRE and a PSA level between 4 and 10 ng/ml, it permits selection of patients with significant hypervascular cancers from those with hypovascular nodules or without TRUS/CDS abnormalities harbouring cancers of significantly lower Gleason score. CDS of the cavernosal arteries is the most accurate means of detecting impotence of vascular origin. Intermediate values of peak systolic velocities (25–35 cm/s) are not conclusive for arterial insufficiency and measurement of other Doppler parameters (systolic rise time and acceleration) are required to confirm arterial insufficiency. End diastolic velocity of below 5 cm/s is a reliable means of guaranteeing a normally functioning veno-occlusive system avoiding the need for cavernometry. Scrotal CDS is useful in evaluating acute scrotal disorders and permits the differentiation of acute torsions from epididymitis when the clinical examination is equivocal. Partial torsions are difficult to identify as they do not impair testicular arterial blood flow. Using spectral analysis may improve the sensitivity of color imaging in these cases. CDS of the spermatic veins is useful for quantifying the importance of non-palpable varicoceles by measuring the length and the pattern of the Doppler curve.

Testicular Artery Ramification Within the Inguinal Canal

Testicular arterial anatomy has been well studied because of its important role in testicular physiology and testicular surgery. Contrary to classical anatomical descriptions, we have observed that often more than 1 branch of the internal spermatic artery is present at the level of the proximal inguinal canal. Many surgeons who perform varicocelectomy assume that only 1 artery is present at this level and ligate all other vascular structures once an artery has been identified. We determine the frequency and number of internal spermatic arteries present within the spermatic cord in the proximal inguinal canal. The number of internal spermatic arteries present at this level was studied in 15 spermatic cords of 12 patients undergoing varicocelectomy using loupe magnification and intraoperative Doppler ultrasound. The number of arteries ranged from 1 to 3, with a mean of 2 arteries. Histological studies of the same area of 17 spermatic cords obtained from cadavers revealed a mean of 2.4 arteries (range 1 to 3). Knowledge of the frequent early branching of the internal spermatic artery will prevent inadvertent interruption of testicular arterial blood flow during operations performed upon the spermatic cord within the inguinal canal.