Azospermik Olgularda Varikoselektomi
Özet
Varikosel erkeğe bağlı infertilitenin en sık görülen nedenlerinden biridir. Bu hastaların semen analizi sonuçları normospermiden azospermiye kadar değişen tabloda karşımıza çıkabilir. Azospermik hastalarda varikoselektomi yapılması tartışmalıdır. Yapılan çalışmalarda semen parametreleri, testiküler sperm elde etme oranı ve gebelik oranı üzerine olumlu etkisi gösterilse de faydası sınırlıdır. Özellikle cerrahinin başarısını öngörücü faktörlerin belirlenmesiyle seçilmiş hastalarda önemli derecede faydası olacağı düşünülmektedir.
Varicocele is one of the most common causes of male infertility. Semen analysis results of these patients may vary from normospermia to azoospermia. Performing varicocelectomy in azoospermic patients is controversial. Although studies have shown a positive effect on semen parameters, testicular sperm retrieval rate and pregnancy rate, its benefit is limited. It is thought that it will be of significant benefit to selected patients, especially by determining the factors that predict the success of surgery.
Referanslar
Turgut H. Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery, 2020;7(3):195-199. Doi: 10.4274/jus.galenos.2020.3333
Jensen, C.F.S., et al. Varicocele and male infertility. Nature Reviews Urology, 2017. 14: 523. doi: 10.1038/nrurol.2017.98
Turgut H. The Effect of Varicocelectomy on the Pregnancy Rate in Patients with Severe Oligospermia. Nigerian Journal of Clinical Practice. 2020 Dec;23(12):1744-1747. doi: 10.4103/njcp.njcp_173_20.
Czaplicki M, Bablok L, Janczewski Z: Varicocelectomy in patients with azoospermia. Archives of Andrology. 1979; 3(1): 51–5. doi: 10.3109/01485017908985048
Weedin JW, Khera M, Lipshultz LI. Varicocele repair in patients with nonobstructive azoospermia: a meta-analysis. Journal of Urology. 2010 Jun;183(6):2309-15. doi: 10.1016/j.juro.2010.02.012.
Tulloch WS. A consideration of sterility factors in the light of subsequent pregnancies. II Sub fertility in the male (Tr Edinburgh Obst Soc Session 104). Edinburgh Medical Journal. (1951) 59:29–34.
Matthews GJ, Matthews ED, Goldstein M. Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia. Fertility and Sterility. 1998 Jul;70(1):71-5. doi: 10.1016/s0015-0282(98)00108-3.
Kim ED, Leibman BB, Grinblat DM, et al. Varicocele repair improves semen parameters in azoospermic men with spermatogenic failure. Journal of Urology 1999;162:737–40.
Kadioglu A, Tefekli A, Cayan S, et al. Microsurgical inguinal varicocele repair in azoospermic men. Urology. 2001 Feb;57(2):328-33. doi: 10.1016/s0090-4295(00)00908-0.
Schlegel PN, Kaufmann J. Role of varicocelectomy in men with nonobstructive azoospermia. Fertility and Sterility. 2004 Jun;81(6):1585-8. doi: 10.1016/j.fertnstert.2003.10.036.
Kiraç M, Deniz N, Biri H. The effect of microsurgical varicocelectomy on semen parameters in men with non-obstructive azoospermia. Current Urology. 2013 Jan;6(3):136-40. doi: 10.1159/000343527.
Inci K, Gunay LM. The role of varicocele treatment in the management of non-obstructive azoospermia. Clinics (Sao Paulo). 2013;68 Suppl 1(Suppl 1):89-98. doi: 10.6061/clinics/2013(sup01)10.
Pasqualotto FF, Sobreiro BP, Hallak J, et al. Induction of spermatogenesis in azoospermic men after varicocelectomy repair: an update. Fertility and Sterility. 2006 Mar;85(3):635-9. doi: 10.1016/j.fertnstert.2005.08.043.
Cakan M, Altuğ U. Induction of spermatogenesis by inguinal varicocele repair in azoospermic men. Archives of Andrology. 2004 May-Jun;50(3):145-50. doi: 10.1080/01485010490425250.
Ishikawa T, Kondo Y, Yamaguchi K, et al. Effect of varicocelectomy on patients with unobstructive azoospermia and severe oligospermia. BJU International. 2008 Jan;101(2):216-8. doi: 10.1111/j.1464-410X.2007.07279.x.
Cocuzza M, Pagani R, Lopes RI, et al. Use of subinguinal incision for microsurgical testicular biopsy during varicocelectomy in men with nonobstructive azoospermia. Fertility and Sterility. 2009 Mar;91(3):925-8. doi: 10.1016/j.fertnstert.2007.12.065.
Esteves SC, Miyaoka R, Roque M, et al. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian Journal of Andrology. 2016 Mar-Apr;18(2):246-53. doi: 10.4103/1008-682X.169562.
Youssef T, Abd-Elaal E, Gaballah G, et al. Varicocelectomy in men with nonobstructive azoospermia: is it beneficial? International Journal of Surgery. 2009 Aug;7(4):356-60. doi: 10.1016/j.ijsu.2009.05.009.
Inci K, Hascicek M, Kara O, et al. Sperm retrieval and intracytoplasmic sperm injection in men with nonobstructive azoospermia, and treated and untreated varicocele. Journal of Urology. 2009 Oct;182(4):1500-5. doi: 10.1016/j.juro.2009.06.028.
Haydardedeoglu B, Turunc T, Kilicdag EB, et al. The effect of prior varicocelectomy in patients with nonobstructive azoospermia on intracytoplasmic sperm injection outcomes: a retrospective pilot study. Urology. 2010 Jan;75(1):83-6. doi: 10.1016/j.urology.2009.09.023.
Jensen S, Ko EY. Varicocele treatment in non-obstructive azoospermia: a systematic review. Arab Journal of Urology. 2021 Jul 26;19(3):221-226. doi: 10.1080/2090598X.2021.1956838.
Aboutaleb HA, Elsherif EA, Omar MK, et al. Testicular Biopsy Histopathology as an Indicator of Successful Restoration of Spermatogenesis after Varicocelectomy in Non-obstructive Azoospermia. World Journal of Men’s Health. 2014 Apr;32(1):43-9. doi: 10.5534/wjmh.2014.32.1.43.
Ustuner M, Yilmaz H, Yavuz U, et al. Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia. Biomed Research International. 2015;2015:709452. doi: 10.1155/2015/709452.
Weedin JW, Khera M, Lipshultz LI. Varicocele repair in patients with nonobstructive azoospermia: a meta-analysis. Journal of Urology. 2010 Jun;183(6):2309-15. doi: 10.1016/j.juro.2010.02.012.
Zhi EL, Liang GQ, Li P, et al. Seminal plasma miR-192a: a biomarker predicting successful resolution of nonobstructive azoospermia following varicocele repair. Asian Journal of Andrology. 2018 Jul-Aug;20(4):396-399. doi: 10.4103/aja.aja_8_18.
Kleiman SE, Yogev L, Gamzu R, et al. Genetic evaluation of infertile men. Human Reproduction. 1999 Jan;14(1):33-8. doi: 10.1093/humrep/14.1.33.
Sofikitis N, Stavrou S, Skouros S, et al. mysteries, facts, and fiction in varicocele pathophysiology and treatment. European Urology Supplements. (2014) 13:89–99. doi: 10.1016/j.eursup.2014.07.002
Comhaire F, Vermeulen A. Varicocele sterility: cortisol and catecholamines. Fertility and Sterility. (1974) 25:88–95. doi: 10.1016/s0015-0282(16)40159-7
Pierik FH, Abdesselam SA, Vreeburg JT, et al. Increased serum inhibin B levels after varicocele treatment. Clinical Endocrinology (Oxf). (2001) 54:775–80. doi: 10.1046/j.1365-2265.2001.01302.x
Jensen, C.F.S., et al. Varicocele and male infertility. Nature Reviews Urology, 2017. 14: 523. doi: 10.1038/nrurol.2017.98
Turgut H. The Effect of Varicocelectomy on the Pregnancy Rate in Patients with Severe Oligospermia. Nigerian Journal of Clinical Practice. 2020 Dec;23(12):1744-1747. doi: 10.4103/njcp.njcp_173_20.
Czaplicki M, Bablok L, Janczewski Z: Varicocelectomy in patients with azoospermia. Archives of Andrology. 1979; 3(1): 51–5. doi: 10.3109/01485017908985048
Weedin JW, Khera M, Lipshultz LI. Varicocele repair in patients with nonobstructive azoospermia: a meta-analysis. Journal of Urology. 2010 Jun;183(6):2309-15. doi: 10.1016/j.juro.2010.02.012.
Tulloch WS. A consideration of sterility factors in the light of subsequent pregnancies. II Sub fertility in the male (Tr Edinburgh Obst Soc Session 104). Edinburgh Medical Journal. (1951) 59:29–34.
Matthews GJ, Matthews ED, Goldstein M. Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia. Fertility and Sterility. 1998 Jul;70(1):71-5. doi: 10.1016/s0015-0282(98)00108-3.
Kim ED, Leibman BB, Grinblat DM, et al. Varicocele repair improves semen parameters in azoospermic men with spermatogenic failure. Journal of Urology 1999;162:737–40.
Kadioglu A, Tefekli A, Cayan S, et al. Microsurgical inguinal varicocele repair in azoospermic men. Urology. 2001 Feb;57(2):328-33. doi: 10.1016/s0090-4295(00)00908-0.
Schlegel PN, Kaufmann J. Role of varicocelectomy in men with nonobstructive azoospermia. Fertility and Sterility. 2004 Jun;81(6):1585-8. doi: 10.1016/j.fertnstert.2003.10.036.
Kiraç M, Deniz N, Biri H. The effect of microsurgical varicocelectomy on semen parameters in men with non-obstructive azoospermia. Current Urology. 2013 Jan;6(3):136-40. doi: 10.1159/000343527.
Inci K, Gunay LM. The role of varicocele treatment in the management of non-obstructive azoospermia. Clinics (Sao Paulo). 2013;68 Suppl 1(Suppl 1):89-98. doi: 10.6061/clinics/2013(sup01)10.
Pasqualotto FF, Sobreiro BP, Hallak J, et al. Induction of spermatogenesis in azoospermic men after varicocelectomy repair: an update. Fertility and Sterility. 2006 Mar;85(3):635-9. doi: 10.1016/j.fertnstert.2005.08.043.
Cakan M, Altuğ U. Induction of spermatogenesis by inguinal varicocele repair in azoospermic men. Archives of Andrology. 2004 May-Jun;50(3):145-50. doi: 10.1080/01485010490425250.
Ishikawa T, Kondo Y, Yamaguchi K, et al. Effect of varicocelectomy on patients with unobstructive azoospermia and severe oligospermia. BJU International. 2008 Jan;101(2):216-8. doi: 10.1111/j.1464-410X.2007.07279.x.
Cocuzza M, Pagani R, Lopes RI, et al. Use of subinguinal incision for microsurgical testicular biopsy during varicocelectomy in men with nonobstructive azoospermia. Fertility and Sterility. 2009 Mar;91(3):925-8. doi: 10.1016/j.fertnstert.2007.12.065.
Esteves SC, Miyaoka R, Roque M, et al. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian Journal of Andrology. 2016 Mar-Apr;18(2):246-53. doi: 10.4103/1008-682X.169562.
Youssef T, Abd-Elaal E, Gaballah G, et al. Varicocelectomy in men with nonobstructive azoospermia: is it beneficial? International Journal of Surgery. 2009 Aug;7(4):356-60. doi: 10.1016/j.ijsu.2009.05.009.
Inci K, Hascicek M, Kara O, et al. Sperm retrieval and intracytoplasmic sperm injection in men with nonobstructive azoospermia, and treated and untreated varicocele. Journal of Urology. 2009 Oct;182(4):1500-5. doi: 10.1016/j.juro.2009.06.028.
Haydardedeoglu B, Turunc T, Kilicdag EB, et al. The effect of prior varicocelectomy in patients with nonobstructive azoospermia on intracytoplasmic sperm injection outcomes: a retrospective pilot study. Urology. 2010 Jan;75(1):83-6. doi: 10.1016/j.urology.2009.09.023.
Jensen S, Ko EY. Varicocele treatment in non-obstructive azoospermia: a systematic review. Arab Journal of Urology. 2021 Jul 26;19(3):221-226. doi: 10.1080/2090598X.2021.1956838.
Aboutaleb HA, Elsherif EA, Omar MK, et al. Testicular Biopsy Histopathology as an Indicator of Successful Restoration of Spermatogenesis after Varicocelectomy in Non-obstructive Azoospermia. World Journal of Men’s Health. 2014 Apr;32(1):43-9. doi: 10.5534/wjmh.2014.32.1.43.
Ustuner M, Yilmaz H, Yavuz U, et al. Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia. Biomed Research International. 2015;2015:709452. doi: 10.1155/2015/709452.
Weedin JW, Khera M, Lipshultz LI. Varicocele repair in patients with nonobstructive azoospermia: a meta-analysis. Journal of Urology. 2010 Jun;183(6):2309-15. doi: 10.1016/j.juro.2010.02.012.
Zhi EL, Liang GQ, Li P, et al. Seminal plasma miR-192a: a biomarker predicting successful resolution of nonobstructive azoospermia following varicocele repair. Asian Journal of Andrology. 2018 Jul-Aug;20(4):396-399. doi: 10.4103/aja.aja_8_18.
Kleiman SE, Yogev L, Gamzu R, et al. Genetic evaluation of infertile men. Human Reproduction. 1999 Jan;14(1):33-8. doi: 10.1093/humrep/14.1.33.
Sofikitis N, Stavrou S, Skouros S, et al. mysteries, facts, and fiction in varicocele pathophysiology and treatment. European Urology Supplements. (2014) 13:89–99. doi: 10.1016/j.eursup.2014.07.002
Comhaire F, Vermeulen A. Varicocele sterility: cortisol and catecholamines. Fertility and Sterility. (1974) 25:88–95. doi: 10.1016/s0015-0282(16)40159-7
Pierik FH, Abdesselam SA, Vreeburg JT, et al. Increased serum inhibin B levels after varicocele treatment. Clinical Endocrinology (Oxf). (2001) 54:775–80. doi: 10.1046/j.1365-2265.2001.01302.x
Sayfalar
69-76
Gelecek
30 Nisan 2024
Telif Hakkı (c) 2024 Akademisyen Yayınevi Kitap Portalı
Lisans
LisansNasıl Atıf Yapılır
1.
Akça G. Azospermik Olgularda Varikoselektomi. Içinde: Turgut H, editör. Güncel Üroloji Çalışmaları V (Bahar) [Internet]. Türkiye: Akademisyen Yayınevi Kitap DOI Portalı; 2024 [a.yer 13 Temmuz 2026]. ss. 69-76. Erişim adresi: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/3059/chapter/13462
