Cut-off values of the Johnsen score and Copenhagen index as histopathological prognostic factors for postoperative semen quality in selected infertile patients undergoing microsurgical correction of bilateral subclinical varicocele.
Testicular biopsy
male infertility
microsurgery
seminal parameters
subclinical varicocele
Journal
Translational andrology and urology
ISSN: 2223-4691
Titre abrégé: Transl Androl Urol
Pays: China
ID NLM: 101581119
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
entrez:
27
9
2019
pubmed:
27
9
2019
medline:
27
9
2019
Statut:
ppublish
Résumé
It remains challenging to determine which individuals are likely to benefit from microsurgical correction of subclinical varicocele, as basic semen parameters often do not improve postoperatively. We aimed to develop an easily accessible tool for prognostic stratification of infertile men indicated for microsurgical correction of bilateral subclinical varicocele characterized by prolonged and clear venous reflux and no other cause for infertility. We retrospectively analyzed the testicular biopsy, seminal analysis, and ultrasound evaluation records of 20 men managed between 2006 and 2014. Subclinical varicocele was diagnosed through bilateral testicular palpation and auscultation of venous reflux using a Doppler stethoscope, with confirmation on color Doppler sonography. We conducted receiver operating characteristic curve analysis to identify the optimal combinations of cut-offs for the Johnsen score, Copenhagen index, and testicular volume defining histological patterns with positive prognostic value for improved postoperatively reproductive capacity. Positive prognostic value was noted for the following combinations of parameters: (I) Johnsen score >8.2 in the left testicle and right testicular volume >12.8 mL predicted improved sperm concentration; (II) Johnsen score >8.2 and Copenhagen index digit II <2.5 bilaterally predicted improved total sperm motility; (III) Johnsen score >9.1 and Copenhagen index digit III <1.5 bilaterally predicted improved progressive sperm motility; (IV) Johnsen score >7.9 and right testicular volume >13.6 mL predicted improved sperm morphology. Johnsen score and Copenhagen index as histopathological prognostic factors can be easily obtained upon evaluation of testicular biopsy specimens and can be simple and reliable tool to establish a more realistic prognosis for reproductive capacity in men who undergo microsurgical correction of subclinical varicocele with no other detectable cause for infertility.
Sections du résumé
BACKGROUND
BACKGROUND
It remains challenging to determine which individuals are likely to benefit from microsurgical correction of subclinical varicocele, as basic semen parameters often do not improve postoperatively. We aimed to develop an easily accessible tool for prognostic stratification of infertile men indicated for microsurgical correction of bilateral subclinical varicocele characterized by prolonged and clear venous reflux and no other cause for infertility.
METHODS
METHODS
We retrospectively analyzed the testicular biopsy, seminal analysis, and ultrasound evaluation records of 20 men managed between 2006 and 2014. Subclinical varicocele was diagnosed through bilateral testicular palpation and auscultation of venous reflux using a Doppler stethoscope, with confirmation on color Doppler sonography. We conducted receiver operating characteristic curve analysis to identify the optimal combinations of cut-offs for the Johnsen score, Copenhagen index, and testicular volume defining histological patterns with positive prognostic value for improved postoperatively reproductive capacity.
RESULTS
RESULTS
Positive prognostic value was noted for the following combinations of parameters: (I) Johnsen score >8.2 in the left testicle and right testicular volume >12.8 mL predicted improved sperm concentration; (II) Johnsen score >8.2 and Copenhagen index digit II <2.5 bilaterally predicted improved total sperm motility; (III) Johnsen score >9.1 and Copenhagen index digit III <1.5 bilaterally predicted improved progressive sperm motility; (IV) Johnsen score >7.9 and right testicular volume >13.6 mL predicted improved sperm morphology.
CONCLUSIONS
CONCLUSIONS
Johnsen score and Copenhagen index as histopathological prognostic factors can be easily obtained upon evaluation of testicular biopsy specimens and can be simple and reliable tool to establish a more realistic prognosis for reproductive capacity in men who undergo microsurgical correction of subclinical varicocele with no other detectable cause for infertility.
Identifiants
pubmed: 31555558
doi: 10.21037/tau.2019.06.23
pii: tau-08-04-346
pmc: PMC6732093
doi:
Types de publication
Journal Article
Langues
eng
Pagination
346-355Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no conflicts of interest to declare.
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