Microsurgical varicocelectomy effects on sperm DNA fragmentation and sperm parameters in infertile male patients: A systematic review and meta-analysis of more recent evidence.

BACKGROUND: Varicocele is known to have impacts in infertility cases and sperm quality. This review aimed to evaluate the effects of microsurgical varicocelectomy on sperm DNA fragmentation index (DFI) and sperm parameters. METHODS: Open full English text articles from January 2017 to October 2021 were searched from online database including PubMed, EMBASE, Scopus, Cochrane Library and Google Scholar. RESULTS: Systematic search resulted in 277 potential papers. After throughout paper analysis, 5 studies were included in this review. From all five analyzed studies, microsurgical varicocelectomy was statistically proven to reduce DNA fragmentation index by 5.46% (mean difference -5.46; 95% CI: -4.79, -6.13; p < 0.00001). Moreover, the procedure also significantly improved other sperm parameters (sperm concentration +8.23%, sperm motility +7.17%, sperm progressive motility +2.77%, sperm morphology +0.64%). CONCLUSION: Microsurgical varicocelectomy significantly improves spermatogenesis as reflected by biomarkers of infertile men including semen parameters and sperm DNA fragmentation (SDF).

Fournier's gangrene in female patient with Turner's syndrome: A case report.

This case reported Fournier's Gangrene (FG) case in 22 year old woman, which is rarely found in young woman, with Turner's Syndrome, vulvar synechiae, uterine agenesis, and voiding disorders. Turner's Syndrome can lead to vulvar synechiae and voiding disorders. This condition is exacerbated by E. coli bacterial infection, causes tissue necrosis and leads to FG. Urgent synechiae incision and necrotomy debridement were successfully performed to remove the necrotic tissue followed by graft closure and flap reconstruction. Rapid administration of broad-spectrum antibiotics is also important. These treatments are considered as the key of successful outcomes of FG.