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Re: Spontaneous Pregnancy Rates in Chinese Men Undergoing Microsurgical Subinguinal Varicocelectomy and Possible Preoperative Factors Affecting the Outcomes
MALE INFERTILITY
1371
Re: A New One-Layer Epididymovasostomy Technique A. Hussein Urology Department, Minia University, El-Minia, Egypt BJU Int 2015; 115: 653e658.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.041 available at http://jurology.com/ Editorial Comment: The intussusception technique made epididymovasostomy simpler and more reliable from a technical standpoint, and microsurgeons consequently embraced it. In this article Hussein describes a new epididymovasostomy technique, where an opening in the epididymal tubule is secured to its overlying tunica, thus presumably providing a larger opening for the anastomosis. Sperm were observed in the ejaculate of 5 of 9 men undergoing this new procedure. Surgery is always a choice of which art the surgeon prefers, and should outcomes in larger series be equivalent to those with intussusception, this technique would add to the surgical toolbox for anastomosing the tiny epididymal tubule to the vas deferens. Craig Niederberger, MD
Re: Spontaneous Pregnancy Rates in Chinese Men Undergoing Microsurgical Subinguinal Varicocelectomy and Possible Preoperative Factors Affecting the Outcomes J. Peng, Z. Zhang, W. Cui, Y. Yuan, W. Song, B. Gao, Z. Xin and S. Zhu Andrology Center and Department of Biostatistics, Peking University First Hospital, Beijing, People’s Republic of China Fertil Steril 2015; 103: 635e639.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.042 available at http://jurology.com/ Editorial Comment: Some well-known, if flawed, analyses of the merits of varicocelectomy cite its unproved improvement in birth outcomes. The problem with focusing on birth is that so many things can happen in between sperm formation in the testicle and delivery of a baby that enormous studies would need to be conducted to statistically demonstrate a positive effect. These investigators evaluated a well selected group of patients with, among other characteristics, only clinically observable varicoceles and abnormal sperm parameters. As the subjects were chosen with no fertility after 1 year, pregnancy rates of 24.8% at 12 months after varicocelectomy and 44.8% at 24 months argue for efficacy of the procedure. If a patient has a clinically significant varicocele, meaning that it can be felt or seen and is not solely identified with imaging, accompanied by abnormal semen parameters, varicocelectomy can be expected to result in pregnancy in about half of the partners within 2 years. Craig Niederberger, MD
Re: Twenty-Four-Hour Monitoring of Scrotal Temperature in Obese Men and Men with a Varicocele as a Mirror of Spermatogenic Function A. Garolla, M. Torino, P. Miola, N. Caretta, D. Pizzol, M. Menegazzo, A. Bertoldo and C. Foresta Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit, University of Padua, Padova, Italy Hum Reprod 2015; 30: 1006e1013.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.043 available at http://jurology.com/ Editorial Comment: The results of this study investigating scrotal temperature in obese men and in those with varicocele are not terribly surprising. Evidence has long supported that heat from any
1371
Re: A New One-Layer Epididymovasostomy Technique A. Hussein Urology Department, Minia University, El-Minia, Egypt BJU Int 2015; 115: 653e658.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.041 available at http://jurology.com/ Editorial Comment: The intussusception technique made epididymovasostomy simpler and more reliable from a technical standpoint, and microsurgeons consequently embraced it. In this article Hussein describes a new epididymovasostomy technique, where an opening in the epididymal tubule is secured to its overlying tunica, thus presumably providing a larger opening for the anastomosis. Sperm were observed in the ejaculate of 5 of 9 men undergoing this new procedure. Surgery is always a choice of which art the surgeon prefers, and should outcomes in larger series be equivalent to those with intussusception, this technique would add to the surgical toolbox for anastomosing the tiny epididymal tubule to the vas deferens. Craig Niederberger, MD
Re: Spontaneous Pregnancy Rates in Chinese Men Undergoing Microsurgical Subinguinal Varicocelectomy and Possible Preoperative Factors Affecting the Outcomes J. Peng, Z. Zhang, W. Cui, Y. Yuan, W. Song, B. Gao, Z. Xin and S. Zhu Andrology Center and Department of Biostatistics, Peking University First Hospital, Beijing, People’s Republic of China Fertil Steril 2015; 103: 635e639.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.042 available at http://jurology.com/ Editorial Comment: Some well-known, if flawed, analyses of the merits of varicocelectomy cite its unproved improvement in birth outcomes. The problem with focusing on birth is that so many things can happen in between sperm formation in the testicle and delivery of a baby that enormous studies would need to be conducted to statistically demonstrate a positive effect. These investigators evaluated a well selected group of patients with, among other characteristics, only clinically observable varicoceles and abnormal sperm parameters. As the subjects were chosen with no fertility after 1 year, pregnancy rates of 24.8% at 12 months after varicocelectomy and 44.8% at 24 months argue for efficacy of the procedure. If a patient has a clinically significant varicocele, meaning that it can be felt or seen and is not solely identified with imaging, accompanied by abnormal semen parameters, varicocelectomy can be expected to result in pregnancy in about half of the partners within 2 years. Craig Niederberger, MD
Re: Twenty-Four-Hour Monitoring of Scrotal Temperature in Obese Men and Men with a Varicocele as a Mirror of Spermatogenic Function A. Garolla, M. Torino, P. Miola, N. Caretta, D. Pizzol, M. Menegazzo, A. Bertoldo and C. Foresta Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit, University of Padua, Padova, Italy Hum Reprod 2015; 30: 1006e1013.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.08.043 available at http://jurology.com/ Editorial Comment: The results of this study investigating scrotal temperature in obese men and in those with varicocele are not terribly surprising. Evidence has long supported that heat from any