Objective: To assess semen analysis, testicular volume, and hormone levels in fertile and infertile patients with varicoceles and fertile mien without varicoceles. Design: Retrospective study. Setting: Academic medical center. Patient(s): Patients were divided into three groups: fertile mien with varicoceles (n = 79), infertile men with vatricoceles (n = 71), and fertile men without varicoceles (n = 217). Intervention(s): None. Main Outcome Measure(s): Levels of LH, FSH, and total T and testicular volume in fertile and infertile men with varicoceles and fertile controls without varicoceles. Result(s): LH (IU/L) and T (ng/dl) levels were not statistically different across the three groups. FSH levels were significantly higher in infertile men with varicoceles (7.8 ± 7.6 IU/L) than in the fertile men with varicoceles (3.5 ± 2.1 IU/L) or in fertile men without varicoceles (3.5 ± 1.9 IU/L). The right testicle was smaller in infertile patients with varicoceles (18.7 ± 8.3 cm 3 ) than in fertile men with varicoceles (25.2 ± 13 cm 3 ) or in fertile men without varicoceles (24.9 ± 10.7 cm 3 ). In addition, the left testicle was smaller in infertile men with varioceles (17.6 ± 8.9 cm 3 ) than in fertile men with varicoceles (21.6 ± 7.8 cm 3 ) or in fertile men without varicoceles (23.4 ± 8.3 cm 3 ). Sperm concentration was lower in infertile men with varicoceles (33.7 ± 23.3 × 10 6 /mL) than in fertile men with varicoceles (101.8 ± 76.6 × 10 6 /mL) or in fertile men without varicoceles (111.8 ± 74.2 × 10 6 /mL). In addition, sperm motility was lower in infertile men with varicoceles (37.2% ± 23.9%) than in fertile men with varicoceles (53.9% ± 17.4%) or fertile men without varicoceles (58.9% ± 15.8%). Conclusion(s): Infertile patients with varicoceles have higher levels of FSH, smaller testes, and lower sperm concentration and motility compared with controls with or without varicoceles. No statistical differenoes were seen in the variables evaluated among the fertile men with incidental varicoceles detected at physical examination and those without varicoceles.

Semen profile, testicular volume, and hormonal levels in infertile patients with varicoceles compared with fertile men with and without varicoceles

Background Ultrasound is the main requested technique for the assessment of traumatic, vascular, neoplastic, and inflammatory testicular pathology. Moreover, the role of ultrasound has broadened over the years along with the introduction of new techniques, such as contrast enhanced ultrasound and ultrasound elastography. Objective An updated representation of the pre-existing Literature evidence for multiparametric ultrasound imaging with particular regard to elastography, in the evaluation of focal and diffuse testicular pathologies, has been presented. Methods The search was performed in PubMed, Cochrane, EMBASE, Web of Science and Scopus databases from the earliest available article (1977) until January 2021. Based on the evidence of the Literature, the current role of US imaging for focal and diffuse testicular pathologies has been reported and illustrated, with emphasis on examination technique, classification, and pitfalls. Results Multiparametric Ultrasound has a recognized role for testicle focal and diffuse disease. Elastography is nowadays recognized as an essential part of the multiparametric ultrasound examination. However, in the setting of testicular pathology this method showed some promising results in the setting of varicocoele and for focal lesions characterization. In the remaining field its role is still under debate. Discussion B-mode ultrasound and color Doppler ultrasound have been for a long time the diagnostic gold standard for testicular pathologies. The introduction of both contrast enhanced ultrasound and elastography in the last two decades has brought to the emergence of the multiparametric ultrasound concept. These methods are currently able to increase diagnostic confidence especially for testicular lesions characterization, with different relevance depending on the pathology under consideration. Conclusion Multiparametric ultrasound testis assessment, with specific regard to elastography is nowadays recommended for focal and diffuse disease evaluation. Further and larger studies are however needed to validate these results and to understand if the role of elastography in testicular pathology may be broadened.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/andr.13067

Role of multiparametric ultrasound in testicular focal lesions and diffuse pathology evaluation, with particular regard to elastography: Review of literature.

The aim of this article is to review the utility of elastography in the day-to-day clinical practice of the urologist. An electronic database search was performed on PubMed and Cochrane Library with a date range between January 2000 and December 2021. The search yielded 94 articles that passed the inclusion and exclusion criteria. The articles were reviewed and discussed by organ, pathology and according to the physical principle underlying the elastographic method. Elastography was used in the study of normal organs, tumoral masses, chronic upper and lower urinary tract obstructive diseases, dysfunctions of the lower urinary tract and the male reproductive system, and as a pre- and post-treatment monitoring tool. Elastography has numerous applications in urology, but due to a lack of standardization in the methodology and equipment, further studies are required.

https://www.mdpi.com/2075-4418/12/7/1727/pdf?version=1658134535

Elastography in the Urological Practice: Urinary and Male Genital Tract, Prostate Excluded—Review

Purpose:To report the different patterns of estradiol levels in infertile men with non-obstructive azoospermia and correlate these levels with their clinical and laboratory findingsMaterials and m

Serum estradiol levels in infertile men with non-obstructive azoospermia

Re: Role of Preoperative Testicular Shear Wave Elastography in Predicting Improvement of Semen Parameters after Varicocelectomy for Male Patients with Primary Infertility.

OBJECTIVES To evaluate testes in patients with varicocele using real-time strain elastography and to correlate the results with the patients' clinical, seminal, and hormonal profiles. METHODS Fifty patients with left varicocele and 20 age-matched control participants were included in the study. All participants were evaluated via a historical interview, clinical examination, including testicular volume and varicocele grade, hormonal assay (total and free testosterone, luteinizing hormone, and follicle-stimulating hormone), computer-assisted semen analysis, and testicular assessment using real-time strain elastography to define the strain ratio and elasticity score. RESULTS Testicular volume and sperm parameters were significantly lower (P < .001), whereas the follicle-stimulating hormone level, strain ratio, and elasticity score were significantly higher (P < .01; P < .001; P < .001, respectively), in the varicocele group. Other hormone levels in the endocrine profile were not significantly different between the groups. Significant negative correlations were found between the elasticity score and testicular volume and the percentage of normal forms (P = .029; P = .005). The varicocele grade showed significant positive correlations with both the strain ratio and elasticity score (P < .001). CONCLUSIONS Strong correlations were found between real-time strain elastography and the testicular volume, varicocele grade, and sperm morphologic characteristics. Real-time strain elastography is a simple, noninvasive investigative modality that can potentially be used to study the structure and function of the testicular tissue in varicocele.

Evaluation of Normal and Varicocele-Bearing Testes Using Real-time Strain Elastography.

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Evaluation of Normal and Varicocele-Bearing Testes Using Real-time Strain Elastography.