VARİKOSELLİ ERİŞKİN HASTALARDA BİLATERAL TESTİKÜLER VOLÜMLERİN ULTRASONOGRAFİ İLE DEĞERLENDİRİLMESİ

Amaç: Bu çalışmada, varikoseli olan erişkin hastalarda bilateral testiküler volümdeğişikliklerinin araştırılması amaçlandı.Yöntem: Bu retropsektif çalışmaya, 51 hasta ve kontrol grubu olarak 25 sağlıklı gönüllü dâhiledildi. Tüm katılımcılarda testiküler volümler hesaplandı. Üç grup oluşturuldu; grup 1: varikoselolan testisler, grup 2: varikosel olmayan karşı testisler ve grup 3: sağlıklı gönüllü kontroller.Veriler normal dağılımlı değildi ve bu yüzden non-parametrik testler yapıldı.Bulgular: Varikoseli olan hastalar ve kontrol grubunu oluşturan sağlıklı gönüllüler arasındayaş, boy ve kilo açısından istatistiksel farklılık saptanmadı. Grup 1 ve grup 2’nin ortalamatestiküler volümleri, grup 3 göre daha düşük olarak bulundu (her ikisi P < 0.001). Testikulervolümler açısından grup 1 ve grup 2 arasında istatistiksel farklılık yoktu (P = 0,247).Sonuç: USG kullanarak yapılan testiküler volüm ölçümleri, varikoselin testisler üzerinde olanhasar verici etkilerinin tespitinde kullanılabilir

Anahtar Kelimeler:

Testis, Varikosel, Volüm, USG

Assessment of Bilateral Testicular Volumes by Ultrasonography in Adult Patients with Varicocele

Objective: In this study, it is aimed to investigate changes in bilateral testicular volume in adultpatients with varicocele.Methods: This cross-sectional study included 51 consecutively recruited patients withvaricocele and 25 healthy control volunteers. In all participants, testicular volumes werecalculated. The following groups were formed: group 1, testicles ipsilateral to varicocele; group2, testicles contralateral to varicocele; and group 3, healthy volunteer controls. The data werenot normally distributed, and therefore, non-parametric tests were performed.Results: There were no statistically significant difference in terms of age, height and weightbetween varicocele patients and healthy volunteers controls. Mean testicular volumes of group1 and group 2 were found to be lower than that of group 3 (both P < 0.001). There was nostatistical difference in terms of testicular volumes between group 1 and group 2 (P = 0,247).Conclusion: Testicular volume measurements using ultrasonography can be used in thedetermination of damaging effects on testes of varicocele

Keywords:

Testis, Varicocele, Volume, US,

PDF

___

Noske HD, Weidner W. Varicocele–a historical perspective. World J Urol 1999;17: 151-157.

Meachman RB, Townsend RR, Rademacher D, Drose JA. The incidence of varicoceles in the general population when evaluated by physical examination, gray scale sonography and color Doppler sonography. J Urol 1994;151: 1535-1538.

World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril 1992;57: 1289-1293.

Sakamoto H, Saito K, Shichizyo T, Ishikawa K, Igarashi A, Yoshida H. Color Doppler ultrasonography as a routine clinical examination in male infertility. Int J Urol 2006;13:1073-1078.

Johnsen SG, Agger P. Quantitative evaluation of testicular biopsies before and after operation for varicocele. Fertil Steril 1978;29: 58-63.

Nieschlag E, Behre M, Schlingheider A, Nashan D, Pohl J, Fischedick AR. Surgical ligation vs. angiographic embolization of the vena spermatica: a prospective randomized study for the treatment of varicocele-related infertility. Andrologia 1993;25: 233-237.

Witt MA, Lipshultz LI. Varicocele: a progressive or static lesion? Urology 1993;42: 541-3.

Sigman M, Jarow JP. Ipsilateral testicular hypotrophy is associated with decreased sperm counts in infertile men with varicoceles. J Urol. 1997;158: 605-607.

Tekgul S, Riedmiller H, Gerharz E, et al. European Association of Paediatric Urology Guidelines on Paediatric Urology.http://www.uroweb.org/gls/pdf/19_Paediatric_Urolo gy.pdf [accessed September 2011].

Pilatz A, Altinkilic B, Köhler E, Marconi M, Weidner. Color Doppler ultrasound imaging in varicoceles: is the venous diameter sufficient for predicting clinical and subclinical varicocele? W World J Urol 2011;29: 645-650.

Liguori G, Trombetta C, Garaffa G, Bucci S, Gattuccio I, Salamè L, Belgrano E. Color Doppler ultrasound investigation of varicocele. World J Urol 2004;22: 378-81.

Paduch DA, Niedzielski J. Repair versus observation in adolescent varicocele: a prospective study.J Urol 1997;158: 1128-1132.

Cayan S, Akbay E, Bozlu M, et al. The effect of varicocele repair on testicular volume in children and adolescents with varicocele. J Urol 2002;168: 731-734.

Keene DJ, Sajad Y, Rakoczy G, Cervellione RM. Testicular volume and semen parameters in patients aged 12 to 17 years with idiopathic varicocele. J Pediatr Surg 2012;47: 383-5.

World Health Organization (WHO). The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril 1992;57: 1289- 1293.

Sayfan J, Siplovich L, Koltun L,et al: Varicocele treatment in pubertal boys prevents testicular growth arrest. J Urol 1997;157:1456–1457.

Pasqualotto FF, Lucon AM, de Góes PM,et al. Testicular growth, sperm concentration, percent motility, and pregnancy outcome after varicocelectomy based on testicular histology. Fertil Steril 2005;83: 362-366.

Zini A, Buckspan M, Berardinucci D, et al. The influence of clinical and subclinical varicocele on testicular volume. Fertil Steril 1997;68: 671-674.

Hienz HA, Voggenthaler J, and Weissbach L. Histological findings in testes with varicocele during childhood and their therapeutic consequences. Eur J Pediatr 1980;133: 139-146.

Sigman M, and Jarow JP. Ipsilateral testicular hypotrophy is asso-ciated with decreased sperm counts in infertile men with varicoceles. J Urol 1997;158: 605-607.

Gat Y, Gornish M, Navon U, Chakraborty J, Bachar GN, Ben- Shlomo I. Right varicocele and hypoxia, crucial factors in male infertility: fluid mechanics analysis of the impaired testicular drainage system. Reprod Biomed Online 2006;13:510-515.

Turner TT, Lopez TJ. Testicular blood flow in peripubertal and older rats with unilateral experimental varicocele and investigation into the mechanism of the bilateral response to the unilateral lesion. J Urol 1990;144: 1018-1021.

Knudson G, Ross L, Stuhldreher D, Houlihan D, Bruns E, Prins G. Prevalence of sperm bound antibodies in infertile men with varicocele: the effect of varicocele ligation on antibody levels and semen response. J Urol 1994;151: 1260- 1262.

Zorgniotti AW, Sealfon AI. Measurement of intrascrotal temperature in normal and subfertile men. J Reprod Fertil 1998;82: 563-566.