Varicocele Group Research Articles

Increased F2-Isoprostane Levels in Semen and Immunolocalization of the 8-Iso Prostaglandin F2α in Spermatozoa from Infertile Patients with Varicocele.

Polyunsaturated fatty acid damages lead to alterations in sperm function. This study aimed to investigate the involvement of F2-isoprostanes (F2-IsoPs), oxidized lipid products from arachidonic acid, in sperm quality impairment. For this purpose, F2-IsoP levels in semen and F2-IsoP localization in spermatozoa were explored in infertile subjects affected by idiopathic infertility or varicocele, as well as in fertile men. As compared to fertile men, in the idiopathic infertility and varicocele groups, sperm concentration, motility, morphology, viability, and fertility index were significantly lower and the mean scores concerning sperm apoptosis, necrosis, and immaturity were significantly higher. The idiopathic infertile group showed a reduction in sperm motility and fertility index, as well as an increase of apoptosis and necrosis percentages, in comparison to the varicocele group. The varicocele group showed the highest levels of F2-IsoPs, a significant increase of sperm immaturity, and a significant correlation between F2-IsoP levels and sperm immaturity. 8-Iso Prostaglandin F2α, biomarker of in vivo F2-IsoP, was clearly localized in sperm midpiece and cytoplasmic residues. Data show that F2-IsoP formation is relevant in semen and sperm from infertile patients with varicocele and high percentage of immaturity, suggesting that a correct fatty acid integrity is needed for sperm maturation.

Effects of Varicocelectomy on Serum Testosterone Levels among Infertile Men with Varicocele.

Background The main purpose of this study is to evaluate the effects of varicocelectomy on serum testoster- one levels and semen quality in infertile men who suffer from varicocele. Materials and MethodsThis prospective study enrolled 115 subjects with clinical varicocele grades II and III and 240 fertile men as the control group. Total volume of testosterone serum level (ng/dl) and semen quality were com- pared before and after microscopic varicocelectomy. We normalized testosterone serum levels for age, grade, and testis size basis. SPSS 20 software was used to analyze the data. All results of continuous variables were reported as mean ± SD. Statistical significance was set at a P<0.05.ResultsThe mean ages of individuals who participated in the treatment (32.2 ± 5.23) and control (32.8 ± 5.27) groups were similar. There were similar mean values for adjusted testosterone levels between the varicocele (567 ± 222 ng/ml) and control (583 ± 263 ng/ml) groups. In the varicocele group, the adjusted testosterone levels insig- nificantly increased to 594 ± 243 ng/ml. Among semen parameters, only mean sperm concentration significantly increased after varicocelectomy.ConclusionDespite increases in sperm concentration, adjusted testosterone levels did not significantly improve after varicocelectomy.

The protective effects of GYY4137 on ipsilateral testicular injury in experimentally varicocele-induced rats.

The aim of the present study was to evaluate whether morpholin-4-ium 4 methoxyphenyl (morpholino) phosphonodithioate (GYY4137) exhibits a protective effect on ipsilateral testicular injury in experimentally varicocele (VC)-induced rats. A total of 48 rats were randomly divided into the following 6 groups (n=8 each): Group A (control group); group B (sham group); group C (VC group); group D (VC group administered 5 mg/kg/day GYY4137); group E (VC group administered 10 mg/kg/day GYY4137) and group F (VC group administered 20 mg/kg/day GYY4137). Indicators of oxidative stress, apoptosis and inflammation were measured to evaluate the effect of GYY4137 on ipsilateral testicular injury. Compared with groups A and B, rats in group C exhibited severe histological changes and an increase in oxidative stress, apoptosis and inflammation. By contrast, amelioration of testicular damage was evident in the group D, E and F that were treated with GYY4137. These results demonstrate that GYY4137 may be a promising therapy to treat VC as it alleviates oxidative stress, apoptosis and inflammation in experimentally VC-induced rats.

The relationship between inflammation and mean platelet volume in varicocele pathophysiology

IntroductionThe mean platelet volume (MPV) is an extensively employed laboratory indicator related to platelet volume and function in inflammatory circumstances. The aim of this study was to assess the relationship between inflammation and mean platelet volume in varicocele pathophysiology. MethodsWe conducted a recent study, which included 131 varicocele subjects and 82 healthy controls. The identification of varicocele was based on the results from both physical examination and color Doppler ultrasound. We analyzed some laboratory markers including haemogram tests in two groups. ResultsThere were no significant differences in the two groups in terms of baseline characteristics. MPV values were statistically higher in the varicocele group (9.73±0.86fL) than in the control group (9.03±0.70fL) (p<0.001). However, no significant relationship between MPV and varicocele grade was found. Furthermore, the receiver-operating characteristic curve analysis suggested the optimum MPV cut-off value for patients with varicocele as 9.05, with a sensitivity and specificity of 77% and 50%, respectively (p<0.001). ConclusionMPV can offer information on varicocele pathophysiology. Increased MPV levels in varicocele patients may be associated with inflammation.

Effect of varicocelectomy treatment on spermatogenesis and apoptosis via the induction of heat shock protein 70 in varicocele‑induced rats.

In the current study, the hypothesis that testicular varicocelectomy improves spermatogenesis and attenuates apoptosis via the induction of heat shock protein 70 (Hsp70) in a rat model of varicocele was investigated. Adult male Wistar rats (n=75) were randomly divided into 5 groups of 15 each: Control, sham, varicocele, varicocelectomy, and varicocelectomy plus Quercetin. A total of 6 weeks after the varicocelectomy, the left testis of all rats was removed for subsequent examination. Histological changes were compared between the groups. The expression of Hsp70 and apoptosis-associated indicators were evaluated based on immunohistochemical, western blot and mRNA expression analyses. Compared with the varicocele group, the varicocelectomy group exhibited a markedly reduced Bcl-2-associated X protein/B-cell lymphoma 2 (Bax/Bcl-2) ratio, and had a decreased expression of caspase-9, cytochrome c (cyt c) and caspase-3 through the intrinsic signal transduction pathways. Quercetin treatment inhibited the protective effects of varicocelectomy. The expression of Hsp70 was increased in the varicocele group which was further elevated by the varicocelectomy. These results indicated that varicocelectomy can reduce the Bax/Bcl-2 ratio, and decrease the levels of caspase-9, cyt c and caspase-3 via the mitochondrial signal transduction pathway. Such protective effects on left testis spermatogenesis and against apoptosis may be due to the induction of Hsp70. The findings of the present study suggested that varicocelectomy has a clear advantage in protecting testicular function and ameliorating spermatogenic cells apoptosis.

Magnesium sulfate protects testis against unilateral varicocele in Rat

The aim of this study was to investigate the effect of magnesium sulfate (MgSO4) on experimental unilateral varicocele-induced in rats. Sixty male Wistar rats were randomly divided into six experimental groups (n = 10). The Control group had no received any medications and surgery. The Sham group had no received any medication, abdominal cavity was opened without varicocele-induced. Varicocele group: abdominal cavity was opened, varicocele done without any medication treatment. In group 4 abdominal cavity was opened, varicocele-induced then animals orally treated with MgSO4 (25 mg/kg) for 42 days. The groups 5 and 6 were similar to group 4, except animals received 50 and 100 mg/kg of MgSO4, respectively. At the end of days 21 and 42, the abdomen was opened, the left testis extracted for histopathological studies. Also, from the cauda epididymis semen samples were collected to determine malondialdehyde, superoxide dismutase and glutathione peroxidase values. According to the results, there was a significant difference in testis damage grade in Varicocele group compared to the Control group (P < 0.05). The MgSO4 significantly improved testis damage grade on day 42 (P < 0.05). The MgSO4 treatment, dose dependently improved seminiferous tubules with many spermatocytes in the seminiferous tubules in experimental unilateral varicocele established rats after 21 and 42 days (P < 0.05). Also, administration of the MgSO4 via a dose dependent manner significantly normalized malondialdehyde, superoxide dismutase and glutathione peroxidase values to the physiologic level in varicocele-induced rats after 21 and 42 days (P < 0.05). These results suggest administration of the MgSO4 protects testis against unilateral varicocele in rat.

Spermatozoal Fractalkine Signaling Pathway Is Upregulated in Subclinical Varicocele Patients with Normal Seminogram and Low-Level Leucospermia.

Background Fractalkine is produced in seminal plasma in small amounts and correlates with sperm motility. Purpose To investigate the possible effect of low-level leucospermia on spermatozoa oxidative stress and sDNA fragmentation in patients with subclinical varicocele and apparently normal seminogram, and also to study the role of spermatozoal fractalkine and its receptor (CX3CR1) gene expression as a marker of spermatozoa inflammatory response. Methods This study included 80 patients with subclinical varicocele (45 fertile and 35 infertile) and 45 age-matched fertile volunteers. In semen samples, fractalkine and CX3CR1 gene expression were investigated by qRT-PCR. Moreover, seminal plasma malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured. Results There are significant decrease in semen quality and significant increase in seminal leucocytes count in subclinical varicocele. Our results show a significant increase in MDA and TAC levels, DNA fragmentation, and expression levels of fractalkine and its receptor (CX3CR1) in subclinical varicocele groups. Conclusion Subclinical varicocele induces seminal and spermatozoal subclinical inflammatory response in the form of low-level leucospermia and increased mRNA expression of the fractalkine signaling pathway, leading to increased spermatozoal ROS production, oxidative stress, and DNA fragmentation. These could cooperate in the pathogenesis of delayed fertility in males with subclinical varicocele.

The effect of aminoguanidine on sperm motility and mitochondrial membrane potential in varicocelized rats.

Objective(s):Increased levels of nitric oxide (NO) in the testicular veins of people suffering from varicocele have already been reported. However, the role of NO-synthase (NOS) isozymes and their inhibitors have not been extensively studied. We aimed to evaluate the inhibitory effects of aminoguanidine (AG), on sperm motility, vitality, and mitochondrial membrane potential (MMP) in varicocelized rats.Materials and Methods:Twenty fore male Wister rats were divided into control, sham, varicocele, and treatment groups. Varicocele and treatment groups underwent partial ligation of left renal vein. Rats in the sham group underwent the same procedures as the varicocele group with the exception of vein ligation. 10 weeks after varicocele induction, sperm parameters were evaluated in all groups. The treatment group received 50 mg/kg AG injection daily for 10 weeks after which they were sacrificed prior to assessment of the parameters. Sperm viability and MMP were assessed by flow cytometry using propidium iodide (PI) and rhodamine 123 (Rh123), respectively.Results:The results of this study show a decrease in sperm viability, motility and MMP in the varicocele group compared with the other groups. After AG injection, we observed that all the parameters were significantly enhanced in the treatment group compared with the other groups. Rh123 staining revealed a positive relation between MMP and sperm motility, whereas PI staining showed a positive relation between sperm motility and viability.Conclusion:The findings of our study show that AG improves sperm motility and MMP, and thus, might be useful in the management of varicocele-related infertility.

The effects of unilateral varicose ovarian vein on antioxidant capacity and oocyte quality in rat ovary.

Several researchers have reported the relationship between infertility in male and varicocele for so many years but the implication of varicocele in female patients is remains elusive. Here, we aim to examine the effects of unilateral varicose ovarian vein on antioxidant capacity and oocyte quality of rat ovary after the experimental creation of varicocele in female rats. In this study, thirty adult female albino rats were divided into three equal groups: Group 1 as the control group has 10 rats, Group 2 as the sham group has 10 rats and they underwent a sham operation and finally Group 3 has the varicocele group has 10 rats. Antioxidant assays for superoxide dismutase, glutathione peroxidase and catalase were performed using specific assay kits and gene expression for Bax, Bmp-15, Hsp-27 and Gdf-9 was done via real time PCR. The adverse effects of the experimentally induced varicocele were reported and recorded on the left ovary compared to the right sided ovary (no varicocele induction) in the varicocele group. Real time PCR data shows that the expression of Gdf-9, Hsp-27 and Bmp-15 genes were all significantly reduced at p≤ 0.05. The results of this study show that reduced gene expression of Bmp-15, Gdf-9 and Hsp-27, increased gene expression of bax and an imbalance between pro-oxidant/antioxidant ratio are few of the several mechanisms by which varicocele may lead to infertility in female.

Relationship between mean platelet volume, platelet distribution width, plateletcrit and varicocele.

Increases in platelet count and platelet indices such as mean platelet volume (MPV), platelet distribution width (RDW) and plateletcrit (PCT) have been reported in a wide range of pathological settings. The aetiology of varicocele, a vascular disease, is poorly defined. In this study, we aimed to examine the relationship between varicocele, platelet count and a series of platelet indices. A total of 69 patients with varicocele and 56 patients without varicocele were enrolled in the study. Patient sperm parameters, platelet, MPV, PDW and PCT values were analysed. There were semen abnormalities in 37 (53.6%) patients in the varicocele group and 19 (33.9%) patients in nonvaricocele group (P<0.05). There was no significant difference in platelet count or platelet indices (MPV, PDW and PCT) between the patients with and without varicocele (P<0.05). There was no statistically significant difference in platelet count or MPV, PDW and PCT between patients with varicocele and the control subjects.

Resveratrol improves reproductive parameters of adult rats varicocelized in peripuberty.

The aim of this study was to investigate the protective action of resveratrol against the reproductive damage caused by left-sided experimental varicocele. There was a reduction of testicular major axis in the varicocele group when compared with the other groups; the testicular volume was reduced in varicocele group in comparison to the sham-control and resveratrol groups. The frequency of morphologically abnormal sperm was higher in varicocele and varicocele treated with resveratrol groups than in sham-control and resveratrol groups. The frequency of sperm with 100% of mitochondrial activity and normal acrosome integrity were lower in varicocele group than in varicocele treated with resveratrol, sham-control and resveratrol groups. Sperm motility was also reduced in varicocele group than in other groups. The sperm DNA fragmentation was higher in varicocele group than in other groups. Testicular levels of malondialdehyde were higher in varicocele and varicocele treated with resveratrol groups. The varicocele and varicocele treated with resveratrol groups had a significantly higher frequency of TUNEL-positive cells than sham-control and resveratrol groups; however, immunolabeling of the testes from varicocele treated with resveratrol group showed a lower number of apoptotic germ cells in comparison with the left testis of rats of the varicocele group. Reproductive alterations produced by varicocele from peripuberty were reduced by resveratrol in adulthood. Resveratrol should be better investigated as an adjuvant in the treatment of varicocele. Daily administration of resveratrol to rats with varicocele from peripuberty improves sperm quality in the adulthood.

Evaluation of enzymatic and non-enzymatic antioxidants in seminal plasma of men with genitourinary infections, varicocele and idiopathic infertility.

This study was aimed to assess the antioxidant enzymatic and non-enzymatic compounds in semen of infertile men. Seventy-four infertile patients were grouped according to their clinical diagnosis: genitourinary infection, varicocele, idiopathic infertility. Semen samples of fertile men represent the control. Semen characteristics were evaluated by light and transmission electron microscopy (TEM). TEM data was quantified with a mathematical formula, which provides numerical scores. Spectrophotometric and HPLC methods were used to measure the amount of reduced (GSH), oxidised glutathione (GSSG), ascorbic acid (AA) and malondialdehyde (MDA, marker of lipid peroxidation) and the activity of glutathione reductase, catalase (CAT), glutathione peroxidase. Infertile groups showed significantly decreased values of sperm parameters vs. In infection and varicocele groups, the seminal MDA levels were significantly increased when compared to controls (p<0.001), indicating an alteration of oxidative status and a peroxidative damage. In infection and varicocele groups, AA levels were reduced (p<0.05) vs. control; in the varicocele group, the GSH levels were also decreased (p<0.05). Significantly higher CAT activity was observed in infection and varicocele groups vs. fertile men (p<0.001 and p<0.05 respectively). The GSH/GSSG ratio was significantly decreased in varicocele and idiopathic infertility groups vs. control (p<0.01). The study of the alteration of a single parameter of oxidative stress or of the antioxidant system may not have a relevant clinical value to estimate male fertilising potential and the background of infertility causes, since complex and multifactorial mechanisms are involved in different pathologies. In our study, each pathology is characterised by a definite pattern of markers such as MDA and enzymatic and non-enzymatic antioxidant compounds. In the different pathologies related to infertility, the identification of the complex of involved parameters could be useful in the diagnosis, prognosis and in the choice of a possible treatment such as specific antioxidant supplements.

Proteomic signatures of infertile men with clinical varicocele and their validation studies reveal mitochondrial dysfunction leading to infertility.

To study the major differences in the distribution of spermatozoa proteins in infertile men with varicocele by comparative proteomics and validation of their level of expression. The study-specific estimates for each varicocele outcome were combined to identify the proteins involved in varicocele-associated infertility in men irrespective of stage and laterality of their clinical varicocele. Expression levels of 5 key proteins (PKAR1A, AK7, CCT6B, HSPA2, and ODF2) involved in stress response and sperm function including molecular chaperones were validated by Western blotting. Ninety-nine proteins were differentially expressed in the varicocele group. Over 87% of the DEP involved in major energy metabolism and key sperm functions were underexpressed in the varicocele group. Key protein functions affected in the varicocele group were spermatogenesis, sperm motility, and mitochondrial dysfunction, which were further validated by Western blotting, corroborating the proteomics analysis. Varicocele is essentially a state of energy deprivation, hypoxia, and hyperthermia due to impaired blood supply, which is corroborated by down-regulation of lipid metabolism, mitochondrial electron transport chain, and Krebs cycle enzymes. To corroborate the proteomic analysis, expression of the 5 identified proteins of interest was validated by Western blotting. This study contributes toward establishing a biomarker “fingerprint” to assess sperm quality on the basis of molecular parameters.

The Impacts of Subclinical Varicoceles on Infertile Males

Background: it is well known that the varicocele affects male fertility and had adverse effects on the findings of the standard seminal analysis. According to size of that veins; the varicoceles are divided into clinical that are discovered in physical examination and their harmful effects are proved and subclinical varicoceles that are only discovered by Doppler examination. And till now, the indication of surgery in cases of subclinical varicocele is still controversial because of poor information about the impact of those non-clinically founded blood vessels on the testicular function.Objective: To assess the seminal fluid, testicular volume, and hormone levels in infertile patients with subclinical varicoceles.Patients and methods: two groups were studied; 79 infertile patients with subclinical varicoceles and 50 healthy males with normal scrotal ultrasound were included as control group. Semen samples were collected from all subjects after at least 48 hours of sexual abstinence in sterile wide containers by masturbation and analyzed for sperm concentration and percentage motility according to WHO criteria (2010). Serum FSH, LH, and Testosterone (T) levels were assessed using Radioimmunoassay. Ultrasound examination was done to evaluate the pampiniform plexus caliber and also measuring the testicular size.Results: LH and Testosterone levels were not statistically different among the two groups. FSH levels were significantly higher in infertile men with subclinical varicoceles than in control group (p&lt;0.04). The testicular size was significantly smaller in subclinical varicocele group. Regarding the sperm concentration and motility, there were also significant lower percentages in infertile men with subclinical varicoceles (p&lt;0.02) and (p&lt;0.05) respectively.Conclusion: Infertile patients with subclinical varicoceles have higher levels of FSH, smaller testes, and lower percentages of sperm concentration and motility.

Does varicocele grade predict the postoperative changes of semen parameters following left inguinal micro-varicocelectomy?

ObjectiveTo evaluate the relationship between preoperative grade and postoperative changes of semen parameters following left inguinal varicocelectomy. MethodsThis study included 44 patients undergoing left microsurgical inguinal varicocelectomy. Internal spermatic veins were classified as large (4 mm or more in diameter), medium (2–4 mm), or small (2 mm or less). Changes in sperm activity, morphology and count were estimated perioperatively. The introperative findings and semen parameters were compared between varicocele groups of grades 2 and 3. ResultsBoth sperm motility and count improved significantly postoperatively (from (31.9 ± 16.3)% to (47.3 ± 15.5)%, from (28.1 ± 28.1) × 106/mL to (52.1 ± 74.2) × 106/mL). In varicoceles with grade 2 and 3, significant differences were found in the number of large veins (0.4 ± 0.6 vs. 1.2 ± 0.7, p < 0.001) and ultrasonographic maximum diameters of spermatic vein in supine and standing positions (2.3 ± 0.4 cm vs. 2.8 ± 0.6 cm, 3.1 ± 0.7 cm vs. 3.9 ± 0.7 cm, p = 0.001 and 0.001 respectively). However no difference of changes in sperm motility and count was detected ((16.3 ± 13.5)% vs. (14.4 ± 12.6)%, (30.5 ± 84.4) × 106/mL vs. (12.9 ± 20.6) × 106/mL respectively, p = 0.65 and 0.40 respectively). ConclusionPreoperative varicocele grade might not predict postoperative semen changes regardless of possible existence of anatomic and ultrasonographic associations.

Spermatozoa protein alterations in infertile men with bilateral varicocele.

Among infertile men, a diagnosis of unilateral varicocele is made in 90% of varicocele cases and bilateral in the remaining varicocele cases. However, there are reports of under-diagnosis of bilateral varicocele among infertile men and that its prevalence is greater than 10%. In this prospective study, we aimed to examine the differentially expressed proteins (DEP) extracted from spermatozoa cells of patients with bilateral varicocele and fertile donors. Subjects consisted of 17 men diagnosed with bilateral varicocele and 10 proven fertile men as healthy controls. Using the LTQ-orbitrap elite hybrid mass spectrometry system, proteomic analysis was done on pooled samples from 3 patients with bilateral varicocele and 5 fertile men. From these samples, 73 DEP were identified of which 58 proteins were differentially expressed, with 7 proteins unique to the bilateral varicocele group and 8 proteins to the fertile control group. Majority of the DEPs were observed to be associated with metabolic processes, stress responses, oxidoreductase activity, enzyme regulation, and immune system processes. Seven DEP were involved in sperm function such as capacitation, motility, and sperm-zona binding. Proteins TEKT3 and TCP11 were validated by Western blot analysis and may serve as potential biomarkers for bilateral varicocele. In this study, we have demonstrated for the first time the presence of DEP and identified proteins with distinct reproductive functions which are altered in infertile men with bilateral varicocele. Functional proteomic profiling provides insight into the mechanistic implications of bilateral varicocele-associated male infertility.

Impact of varicocele on biological markers of gonadal function.

The aim of this study is to evaluate the potential effect of varicocele in the hormonal and clinical profile of adolescents. Twenty adolescents at Tanner stage 4-5 with left varicocele were studied and compared with a control group of 20 healthy adolescents. All patients underwent ultrasonographic testicular volumetry as well as hormonal evaluation of inhibin B, testosterone, baseline and gonadotropin-releasing hormone stimulated, follicle-stimulating hormone as well as luteinizing hormone. Statistical analysis was performed using the student's t test with p value <0.05 taken as statistical significant. Patients with varicocele showed reduced levels of inhibin B compared to controls and a significant reduction in the testicular volume on the affected side. The response of luteinizing hormone to gonadotropin-releasing hormone stimulation was significantly higher in the varicocele group compared to the control group. Furthermore a significant inverse relationship of inhibin B compared to follicle-stimulating hormone was noted. Serum inhibin B levels could represent a useful marker of Sertoli cell damage caused by varicocele.

Major protein alterations in spermatozoa from infertile men with unilateral varicocele.

BackgroundThe etiology of varicocele, a common cause of male factor infertility, remains unclear. Proteomic changes responsible for the underlying pathology of unilateral varicocele have not been evaluated. The objective of this prospective study was to employ proteomic techniques and bioinformatic tools to identify and analyze proteins of interest in infertile men with unilateral varicocele.MethodsSpermatozoa from infertile men with unilateral varicocele (n = 5) and from fertile men (control; n = 5) were pooled in two groups respectively. Proteins were extracted and separated by 1-D SDS-PAGE. Bands were digested and identified on a LTQ-Orbitrap Elite hybrid mass spectrometer system. Bioinformatic analysis identified the pathways and functions of the differentially expressed proteins (DEP).ResultsSperm concentration, motility and morphology were lower, and reactive oxygen species levels were higher in unilateral varicocele patients compared to healthy controls. The total number of proteins identified were 1055, 1010 and 1042 in the fertile group, and 795, 713 and 763 proteins in the unilateral varicocele group. Of the 369 DEP between both groups, 120 proteins were unique to the fertile group and 38 proteins were unique to the unilateral varicocele group. Compared to the control group, 114 proteins were overexpressed while 97 proteins were underexpressed in the unilateral varicocele group. We have identified 29 proteins of interest that are involved in spermatogenesis and other fundamental reproductive events such as sperm maturation, acquisition of sperm motility, hyperactivation, capacitation, acrosome reaction and fertilization. The major functional pathways of the 359 DEP related to the unilateral varicocele group involve metabolism, disease, immune system, gene expression, signal transduction and apoptosis. Functional annotations showed that unilateral varicocele mostly affected small molecule biochemistry and post-translational modification proteins. Proteins expressed uniquely in the unilateral varicocele group were cysteine-rich secretory protein 2 precursor (CRISP2) and arginase-2 (ARG2).ConclusionsThe expression of these proteins of interest are altered and possibly functionally compromised in infertile men with unilateral varicocele. If validated, these proteins may lead to potential biomarker(s) and help better understand the mechanism involved in the pathophysiology of unilateral varicocele in infertile men.Electronic supplementary materialThe online version of this article (doi:10.1186/s12958-015-0007-2) contains supplementary material, which is available to authorized users.

腹腔镜与显微镜下治疗青年精索静脉曲张疗效分析

目的：探讨腹腔镜与显微镜下治疗青年原发性精索静脉曲张的疗效、安全性。方法：回顾性分析71名青年原发性精索静脉曲张患者治疗后随访资料，其中有5例慢性前列腺炎患者。39例接受腹腔镜精索静脉高位结扎术(腹腔镜组)，2例慢性前列腺炎患者；32例接受显微镜下精索静脉结扎组(显微镜组)，3例慢性前列腺炎患者。比较两组患者术前、术后3月精液质量、激素水平、睾丸体积变化情况及手术时间、住院天数、费用。结果：两组患者手术均顺利完成，腹腔镜组与显微镜组相比手术时间明显缩短(85.94 ± 20.44 vs 39.00 ± 9.69, P 0.05)。两组患者术后精液质量较术前无差异(P > 0.05)，精子密度、精子存活率、A + B级精子明显改善，差异有统计学意义(P 0.05)。腹腔镜组术后2例(5.1%)复发，1例(2.6%)附睾炎，2例(5.1%)症状持续存在，2例(5.1%)阴囊水肿；显微镜组术后无复发、附睾炎、阴囊水肿，但是有1例(3.1%)患者症状持续存在。结论：青年精索静脉曲张患者精液质量大多已受影响，早期手术可以恢复精液质量或减轻精液质量的下降。腹腔镜与显微镜下治疗精索静脉曲张均为微创手术，创伤小、疗效好，但是显微镜下治疗精索静脉曲张费用低、术后复发率低、并发症更少。 Objective: To compare curative effect between microscopic and laparoscopic approach for treatment of varicocele. Method: We retrospectively analyzed 71 adolescence varicocele patients after treatment follow-up data. 39 cases underwent laparoscopic high ligation of spermatic vein (laparoscopic group). 32 patients received ligation of varicocele group under the microscope (microscopy group). The semen quality, hormone levels and testicular volumes of these two groups of patients before and after the operation, operation time, hospitalization days and cost were compared. Results: All patients were successfully completed the operation. Laparoscopic group compared with microscope group operation time is obviously shortened (85.94 + 20.44VS39.00 + 9.69, P 0.05), but the cost was significantly increased (4866 + 541.45VS7820 + 906.21, P < 0.05). Compared with preoperative semen quality, postoperative semen quality of these two groups of patients showed no statistical significance. Sperm density, sperm survival rate, A + B grade sperm significantly improved (P < 0.05). In the laparoscopic group after operation, 2 cases (5.1%) of recurrence, 1 case (2.6%) of patients with epididymitis; 2 cases (5.1%) clinical symptoms persisted and 2 cases (5.1%) occurred scrotal edema. However, no recurrence, epididymitis, scrotal edema in the microscope group after operation, but 1 case (3.1%) of patients with persistent symptoms. Conclusion: Most of the youth semen quality of patients with varicocele has affected; early operation can restore the semen quality or decrease the damage level of semen quality. Laparoscopic and microscope to treat varicocele were minimally invasive operation. They have the characteristics of small trauma, good curative effect, but the microsurgical operation has the advantages of low cost, lower postoperative recurrence rate and fewer complications characteristics.

Seminal Tumour necrosis factor-related apoptosis-inducing ligand and its relationship to infertility in Egyptian patients with varicocele.

Germ cell apoptosis has been proposed as one of the mechanisms by which varicocele can influence fertility. The aim of this study was to investigate the relationship between seminal tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) levels and male infertility in patients with varicocele. This study included 112 males: 30 fertile males with varicocele, 44 infertile males with varicocele and 38 healthy fertile control subjects without varicocele. Semen analysis was performed, and serum levels of reproductive hormones were measured. Seminal TRAIL levels in the infertile varicocele group were significantly higher than in the fertile varicocele and the control groups (P = 0.014). A significant negative correlation was found between seminal TRAIL and progressive (P < 0.001) and total motility scores (P < 0.001) in the infertile varicocele group. A significant negative correlation was also detected between seminal TRAIL levels and normal sperm morphology in the fertile varicocele (P = 0.007) and infertile varicocele patients (P = 0.047). Seminal TRAIL was significantly correlated with varicocele grade whether the patients were fertile (P = 0.001) or infertile (P = 0.035). Seminal TRAIL may thus have a potential role in varicocele-associated male infertility through its negative effect on sperm motility and morphology.