Altered brain activity associated with premature ejaculation improved by electroacupuncture in rats.

Background: Premature ejaculation (PE) is linked with abnormal brain activity that is modifiable by electroacupuncture (EA). Aim: In this study we aimed to explore the central pathological mechanism underlying EA in treating PE. Methods: Six-week-old male Sprague-Dawley rats were divided into a PE group (n = 8) and a control group (n = 8) according to ejaculatory frequency during copulatory behavior. All rats underwent EA at the Zusanli acupoint (ST-36) for 4 weeks. Magnetic resonance imaging data were collected before and after EA. Outcomes: The behavioral parameters, plasma norepinephrine levels, fractional amplitude of low frequency fluctuation (fALFF), and regional homogeneity (ReHo) were evaluated. Results: The PE group ejaculated more times with shorter latency compared with controls. After EA, the ejaculation frequency of the PE group decreased, and the ejaculation latency period increased, with no changes observed in the control group. Norepinephrine levels were higher in the PE group than in the controls and were positively correlated with ejaculation frequency and negatively correlated with ejaculation latency. The PE group showed lower fALFF in the right striatum and higher ReHo in the brainstem compared with controls. After EA, controls showed decreased fALFF in the right striatum, left olfactory bulb, and dorsal fornix and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, prelimbic system, right basal forebrain region, septal region, and olfactory bulb, while the model group exhibited increased fALFF in the right hypothalamic region, decreased fALFF in the left globus pallidum and right basal forebrain region and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, olfactory bulb, basal forebrain region, dentate gyrus, right dysgranular insular cortex, and striatum. Compared with the controls after EA, the model group showed increased ReHo of the right hypothalamic region and decreased ReHo of the right dysgranular insular cortex. Clinical Implications: These findings might enhance the understanding of PE and contribute to new, targeted therapies for PE. Strengths and Limitations: The therapeutic effects might be achieved by EA inhibiting the activity in brain regions involved in ejaculatory behavior. However, the curative effect of acupuncture might be underestimated due to some curative effects of sham acupuncture used in the control group. Conclusion: In conclusion, the ejaculatory frequency of rats may be reduced and ejaculation latency could be extended by EA at ST-36, which might be achieved by the effects of this treatment on brain activity.

Altered regional brain activity and functional connectivity in primary intravaginal anejaculation patients revealed by resting-state fMRI.

ABSTRACT: Ejaculation is regulated by the central nervous system. However, the central pathophysiology of primary intravaginal anejaculation (PIAJ) is unclear. The present study aimed to examine the changes in regional brain activity and functional connectivity underlying PIAJ. A total of 20 PIAJ patients and 16 healthy controls (HCs) were enrolled from September 2020 to September 2022 in the Department of Andrology, Nanjing Drum Tower Hospital (Nanjing, China). Magnetic resonance imaging data were acquired from all participants and then were preprocessed. The measures of fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) were calculated and compared between the groups. PIAJ patients showed increased fALFF values in the left precuneus compared with HCs. Additionally, PIAJ patients showed increased ReHo values in the left precuneus, left postcentral gyrus, left superior occipital gyrus, left calcarine fissure, right precuneus, and right middle temporal gyrus, and decreased ReHo values in the left inferior parietal gyrus, compared with HCs. Finally, brain regions with altered fALFF and ReHo values in PIAJ patients showed increased FC with widespread cortical regions, which included the frontal, parietal, temporal, and occipital regions, compared with HCs. In conclusion, increased regional brain activity in the parietal, temporal, and occipital regions, and increased FC between these brain regions, may be associated with PIAJ occurrence.

The application of intraoperative neurophysiological monitoring in selective dorsal neurotomy for primary premature ejaculation: a prospective single-center study.

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.

[Analysis of blood flow of penile cavernous artery in 2 568 cases of erectile dysfunction].

OBJECTIVE: To analyze the blood flow parameters of the cavernous arteries of ED patients after injection of vasoactive drugs, and to explore the differences in blood flow of the cavernous arteries in different erectile states. METHODS: Retrospectively analyzed the penile cavernous arterial blood flow parameters of 2568 adult male ED patients after injection of the vasoactive drug (alprostadil). The patients were divided into three groups: maintaining erection group with EHS (erection hardness score) ≥ 3 and sustained erection time ≥ 20 minutes (967 cases), nonpersistent erection group with EHS≥3 and sustained erection time<5 minutes (788 cases), and incomplete erection group with EHS<3 (813 cases). Compared the parameters of age, EHS, duration of erection, cavernous artery peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) among the three groups respectively. The maintaining erection group was divided into the youth group (757 cases) which aged less than 40 years old and the middle-aged and elderly group (210 cases) with 40 years old or over. The parameters of PSV, EDV and RI between the two groups were compared. The incomplete erection group were divided into the good blood supply group (407 cases) with the bilateral PSV ≥35cm/s and the insufficient blood supply group (252 cases) with the bilateral PSV<35cm/s. The parameters of age, EHS, EDV and RI between the two groups were compared. RESULTS: The age, PSV, EDV and RI of the three groups were significantly different (P<0.01). In the maintaining erection group, the PSV of the young group was significantly higher than that of the middle-aged and elderly group (P<0.05), but there was no statistically significant difference in EDV and RI (P>0.05). In the incomplete erection group, the EHS, PSV, EDV, and RI of the good blood supply group were significantly higher than those of the insufficient blood supply group (P<0.05), while the age was significantly lower than that of the latter (P<0.01). CONCLUSION: The injection of vasoactive drugs combined with color Doppler ultrasound can directly reflect the blood supply of the cavernous arteries of the penis. The better the erection state, the better the blood supply of cavernous arteries. The middle-aged and elderly people are more likely to have cavernous arteries problem of insufficient blood supply than the young people.

Photoredox cooperative N-heterocyclic carbene/palladium-catalysed alkylacylation of alkenes.

Three-component carboacylation of simple alkenes with readily available reagents is challenging. Transition metal-catalysed intermolecular carboacylation works for alkenes with strained ring or directing groups. Herein, we develop a photoredox cooperative N-heterocyclic carbene/Pd-catalysed alkylacylation of simple alkenes with aldehydes and unactivated alkyl halides to provide ketones in good yields. This multicomponent coupling reaction features a wide scope of alkenes, broad functional group compatibility and free of exogenous photosensitizer or external reductant. In addition, a series of chlorinated cyclopropanes with one or two vicinal quaternary carbons is obtained when chloroform or carbon tetrachloride is used as the alkyl halide. The reaction involves the alkyl radicals from halides and the ketyl radicals from aldehydes under photoredox cooperative N-heterocyclic carbene/Pd catalysis.

[Artificial intelligence-based fluorescence method versus traditional flow cytometry in detection of sperm DNA fragmentation index].

OBJECTIVE: To compare the result of the artificial intelligence (AI) recognition-based fluorescence method and that of traditional flow cytometry in the examination of the sperm DNA fragmentation index (DFI) and assess the reliability of the AI-based fluorescence detection. METHODS: Using flow cytometry and the AI-based fluorescence method, we examined the sperm DFI in the semen samples collected from 338 outpatients. We analyzed the correlation between the results and compared the positive rates detected by the two methods. We repeated the AI-based fluorescence method twice for each semen sample to observe its technical stability in the detection of sperm DFI. RESULTS: The result of flow cytometry was well correlated with that of the AI-based fluorescence method in the detection of sperm DFI (R2 = 0.7131), but poorly correlated for low-concentration, sticky semen and some other extreme samples (R2 = 0.2065). No statistically significant difference was found between the two methods in the positive rate of detection. The AI-based fluorescence method exhibited an excellent technical stability (R2 = 0.9671). CONCLUSION: The AI-based fluorescence method has an excellent technical stability in the detection of sperm DFI and the result is not significantly different from that of traditional flow cytometry.

[Impacts of different Y chromosome microdeletions on spermatogenesis].

OBJECTIVE: To study the semen parameters of the patients with Y chromosome microdeletions and their impacts on the spermatogenesis of the patients. METHODS: We selected 151 male infertility patients with Y chromosome microdeletions from those diagnosed and treated in our hospital and retrospectively analyzed the influence of their semen parameters on the spermatogenic function. RESULTS: Of the 151 cases of Y chromosome microdeletions, AZFc was involved in 102 (66.89%), AZFb in 6 (3.97%), AZFa in 5 (3.31%), AZFa+c in 1 (0.66%), AZFb+c in 6 (3.97%), AZFc+d in 1 (0.66%), AZFb+c+d in 13 (8.61%), AZFa+b+c+d in 12 (7.95%), sY127 in 3 (1.99%), sY134 in 1 (0.66%) and sY86 in 1 (0.66%). Among the total number of the infertility patients, 48 (31.78%) were diagnosed with azoospermia, 74 (49%) with cryptozoospermia, 28 (18.54) with oligoasthenozoospermia and 1 (0.66%) with asthenoteratozoospermia. CONCLUSIONS: Y chromosome microdeletions may lead to decreased sperm quality, and different types of deletion have different impacts on the spermatogenic function of the patients.

Dynamic Kinetic Resolution of α-Trifluoromethyl Hemiaminals without α-Hydrogen via NHC-Catalyzed O-Acylation.

Following the well-recognized dynamic kinetic resolution (DKR) of hemiaminals with α-hydrogen under lipase and chiral DMAP catalysis, the unprecedented DKR of hemiaminals without α-hydrogen was developed via N-heterocyclic carbene catalyzed O-acylation of 3-hydroxy-3-trifluoromethylbenzosultams. The racemic hemiaminals without α-hydrogen were effectively racemized and differentiated by chiral NHCs under basic conditions. The resulting esters were obtained in high yields with good to high enantioselectivities.

NHC/Copper-Cocatalyzed [4 + 3] Annulations of Salicylaldehydes with Aziridines for the Synthesis of 1,4-Benzoxazepinones.

N-heterocyclic carbene/copper-cocatalyzed [4 + 3] annulation of salicylaldehydes with aziridines was developed, giving the corresponding 1,4-benzoxazepinones in good yields with exclusive regioselectivity. Copper serves as a Lewis acid to activate the small strained aziridines, and the formation of NHC-salicylaldehyde adduct plays an important role in improving the regioselectivity.

N-Heterocyclic carbene-catalyzed ß-addition of enals to 3-alkylenyloxindoles: synthesis of oxindoles with all-carbon quaternary stereocenters.

The N-heterocyclic carbene-catalyzed ß-addition of enals to 3-alkylenyloxindoles was developed. All of the ß-aryl, ß-alkenyl and ß-alkyl enals worked well for the reaction to give the corresponding 3,3-disubstituted oxindoles bearing contiguous all-carbon quaternary and tertiary stereocenters in good yields with moderate to high diastereoselectivities and excellent enantioselectivities.

Visible light mediated oxidative lactonization of 2-methyl-1,1'-biaryls for the synthesis of benzocoumarins.

A visible light mediated oxidative lactonization of 2-methyl-1,1'-biaryls was developed, giving benzocoumarins in good yields. The reaction features multiple C-H functionalization processes with oxygen as the final oxidant. The corresponding 2-aldehdyes, alcohols and carboxylic acids of the 1,1'-biaryls also worked well for the reaction.

[Updated application of penile electrophysiological examination in the diagnosis and treatment of male sexual dysfunction].

Electrophysiological examination of penile nerves involves detection of somatic and autonomic nerves, including dorsal nerve somatosensory evoked potential, cavernous muscle reflex, skin sympathetic response, cavernous electromyography, and others, which plays an important role in the diagnosis of male sexual dysfunction, such as ED and premature ejaculation, as well as in the selection of treatment methods and evaluation of therapeutic effects. Due to the complex mechanisms of the brain, spinal cord and peripheral nerve pathways relating to erectile and ejaculatory centers in men and many unknown areas in penile electrophysiological techniques, penile electrophysiological examination has not been widely accepted by doctors and patients. Further studies are needed to provide more scientific and convincing evidence in this field.

[Penile hemodynamics in different erection phases].

OBJECTIVE: To compare the hemodynamic indexes of penile cavernosal arteries in different phases of penile erection and determine the optimal time for color Doppler ultrasonography of the penis. METHODS: Forty healthy adult male volunteers with normal erectile function received intracavernous injection of 10 µg Alprostadil together with visual and auditory stimuli. Within the next 30 minutes, we monitored dynamically the blood flow in the bilateral penile cavernosal arteries, and recorded and compared the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) in the phases of latency, tumescence, full erection and rigid erection. RESULTS: Fourteen of the subjects experienced latency, tumescence and full erection only, but failed to achieve rigid erection. PSV and RI were significantly higher while EDV remarkably lower in the tumescence and full erection phases than in the latency phase (all P < 0.01). Statistically significant differences were observed between the tumescence and full erection phases in EDV and RI (both P < 0.01) but not in PSV (P > 0.05). Among the 26 males that achieved rigid erection, PSV, EDV and RI showed significant differences between the full and rigid erection phases (all P < 0.01), but not between the left and right cavernosal arteries in the same phase (P > 0.05). CONCLUSIONS: The blood flow in the penile cavernosal arteries changes dynamically in the process of penile erection, and the hemodynamic indexes obtained in the full erection phase can better reflect the function of penile cavernous vessels.

[Surgical plane positioning with a disposable circumcision suture device for the treatment of phimosis and redundant prepuce].

OBJECTIVE: To investigate the clinical effects of circumcision by surgical plane positioning with a disposable circumcision suture device in the treatment of phimosis and redundant prepuce. METHODS: From September 2016 to June 2017, we treated 250 patients with phimosis or redundant prepuce, 127 by conventional circumcision (the control group) and the other 123 by surgical plane positioning with a disposable circumcision suture device (the observation group). We compared the operation time, intra-operative bleeding, preputial frenulum alignment, postoperative ecchymosis, and postoperative penile appearance between the two groups of patients. RESULTS: Compared with the controls, the patients in the observation group showed significantly longer operation time (ï¼»4.48 ± 1.18ï¼½ vs ï¼»7.17 ± 1.42ï¼½ min, P<0.05), lower rates of intra-operative frenulum bleeding (15.0% ï¼»19/127ï¼½ vs 4.1% ï¼»5/123ï¼½, P<0.05) and frenulum misalignment (26.8% ï¼»34/127ï¼½ vs 0.8% ï¼»1/123ï¼½, P<0.05), higher incidence of postoperative ecchymosis (41.7% ï¼»53/127ï¼½ vs 21.1% ï¼»26/123ï¼½, P<0.05), and higher satisfaction of the patients with the postoperative penile appearance (92.9% ï¼»18/127ï¼½ vs 98.4% ï¼»121/123ï¼½, P<0.05). However, no statistically significant difference was found between the control and observation groups in intra-operative non-frenulum bleeding (4.7% ï¼»6/127ï¼½ vs 1.6% ï¼»2/123ï¼½, P = 0.164). CONCLUSIONS: Circumcision by surgical plane positioning with a disposable circumcision suture device can effectively avoid preputial frenulum misalignment, reduce intra-operative bleeding, and improve postoperative penile appearance.

DBU-Mediated Construction of 1,3,5-Trisubstituted Benzenes via Annulation of α,ß-Unsaturated Carboxylic Acids and α-Cyano-ß-methylenones.

A DBU-mediated synthesis of 1,3,5-trisubstituted benzenes was developed via the [2 + 4] annulation of in situ activated α,ß-unsaturated carboxylic acids and α-cyano-ß-methylenones. The dual role of DBU as Brønsted base and nucleophilic Lewis base is the key for the success of the reaction.

[Clinical application of the disposable vasographic interventional therapy kit in vasoseminal vesiculography].

OBJECTIVE: To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK). METHODS: This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia. RESULTS: Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography. CONCLUSIONS: The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.

No effect of abstinence time on nerve electrophysiological test in premature ejaculation patients.

The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation (PPE) in our previous studies. However, no study verifies if the results will be affected by abstinence time. From January to December in 2016, fifty PPE patients ejaculated within 2 min and 28 control subjects were enrolled. The nerve electrophysiological tests, including dorsal nerve somatosensory evoked potential (DNSEP), glans penis somatosensory evoked potential (GPSEP), and penile sympathetic skin response (PSSR), were recorded before and immediately after ejaculation. The abstinence day was not correlated with the latencies of SEPs or PSSR neither in PE group (P = 0.170, 0.064, and 0.122, respectively) nor in control group (P = 0.996, 0.475, and 0.904, respectively). No statistically differences were found in the latencies of SEPs and PSSR before and after ejaculation in PE patients (P = 0.439, 0.537, and 0.576, respectively) or control subjects (P = 0.102, 0.198, and 0.363, respectively). Thus, abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients.

Comparison of surgical effect and postoperative patient experience between laparoendoscopic single-site and conventional laparoscopic varicocelectomy: a systematic review and meta-analysis.

The present meta-analysis was conducted to compare the clinical effect and patient experience of laparoendoscopic single-site varicocelectomy (LESSV) and conventional laparoscopic varicocelectomy. The candidate studies were included after literature search of database Cochrane Library, PubMed, EMBASE, and MEDLINE. Related information on essential data and outcome measures was extracted from the eligible studies by two independent authors, and a meta-analysis was conducted using STATA 12.0 software. Subgroup analyses were conducted by study design (RCT and non-RCT). The odds ratio (OR) or standardized mean difference (SMD) and their 95% confidence intervals (95% CIs) were used to estimate the outcome measures. Seven articles were included in our meta-analysis. The results indicated that patient who had undergone LESSV had a shorter duration of back to work (overall: SMD = -1.454, 95% CI: -2.502--0.405, P = 0.007; non-RCT: SMD = -2.906, 95% CI: -3.796--2.017, P = 0.000; and RCT: SMD = -0.841, 95% CI: -1.393--0.289, P = 0.003) and less pain experience at 3 h or 6 h (SMD = -0.447, 95% CI: -0.754--0.139, P = 0.004), day 1 (SMD = -0.477, 95% CI: -0.905--0.05, P = 0.029), and day 2 (SMD = -0.612, 95% CI: -1.099--0.125, P = 0.014) postoperatively based on RCT studies. However, the meta-analyses based on operation time, clinical effect (improvement of semen quality and scrotal pain relief), and complications (hydrocele and recurrence) yielded nonsignificant results. In conclusion, LESSV had a rapid recovery and less pain experience over conventional laparoscopic varicocelectomy. However, there was no statistically significant difference between the two varicocelectomy techniques in terms of the clinical effect and the incidence of hydrocele and varicocele recurrence. More high-quality studies are warranted for a comprehensive conclusion.

[Contrast-enhanced ultrasonography in the diagnosis of venous erectile dysfunction].

OBJECTIVE: To investigate the effect and safety of contrast-enhanced ultrasonography (CEUS) in the diagnosis of venous erectile dysfunction (VED). METHODS: From June 2015 to March 2016, 43 ED patients underwent corpus cavernography, of whom 23 were diagnosed with and the other 20 without corpus cavernosal venous leakage (CCVL). All the patients received intracorporal injection of a vasoactive drug and CEUS. RESULTS: Of the 23 patients with CCVL, 21 were confirmed by CEUS, including 12 cases of double venous leakage, 2 cases of single venous leakage, 5 cases of crural venous leakage, and 2 cases of the mixed type, while the other 2 showed no CCVL on CEUS. Of the 20 patients with CCVL, 2 presented CCVL on CEUS. CONCLUSIONS: CEUS has the advantages of accuracy, safety, and less invasiveness in the diagnosis of VED.

[Impact of varicocele and varicocelectomy on the apoptosis of spermatogenic cells and the levels of nitrogen monoxidum and interleukin 1 in the rat testis].

OBJECTIVE: To study the impact of left varicocele (VC) and varicocelectomy (VCT) on the apoptosis of spermatogenic cells and the levels of nitrogen monoxidum (NO) and interleukin 1 (IL-1) in the rat testis. METHODS: We randomly divided 60 adolescent male SD rats into four groups of equal number: sham operation control, VC model 1 (VC1), VC model 2 (VC2), and VCT. We determined the semen quality and levels of NO and IL-1 in the testis tissue, detected the apoptosis of spermatogenic cells by TUNEL, and compared the indexes obtained among different groups. RESULTS: An experimental VC model was successfully established by partially ligating the left renal vein of the rats. Sperm concentration and motility were significantly decreased in the VC1 ([1.54 ± 1.16] x 106/ml and [44.23 ± 15.46]%) as compared with those in the sham operation group ([2.80 ± 1.62] x 106/ml and [72.34 ± 12.62]%) (P < 0.05), but remarkably higher in the VCT ([1.82 ± 1.34] x 106/mI and [51.21 ± 12.62]%) than in the VC2 group ([1.04 ± 1.21] x 106/ml and [39.23 ± 13.21]%) (P < 0.05). The levels of NO and IL-1 in the left testes were markedly elevated in the VC1 ([0.172 ± 0.030] ng/ml and [1.468 ± 0.080 ] mg/ml) in comparison with those in the sham operation group ([0.134 ± 0.021] ng/ml and [0.782 ± 0.079 ] mg/ml) (P < 0.05), and significantly higher in the VC2 ([0.198 ± 0.020] ng/ml and [1.994 ± 0.090] mg/ml) than in the VCT group ([0.141 ± 0.010] ng/ml and [0.781 ± 0.036] mg/ml) (P < 0.05). However, the NO and IL-1 levels in the right testis showed no statistically significant differences between the two groups, and the two levels were positively correlated (r = 0.492, P < 0.01). The rats of the VC1 group exhibited remarkable apoptosis of spermatogenic cells in the bilateral testes, with significant differences in the apoptosis index ( AL) between the two sides (P < 0.05) as well as in the same side in comparison with the sham operation group (P < 0.01). The Als of spermatogenic cells in the bilateral testes showed statistically significant differences in the VCT (P < 0.05) but not in the VC2 group (P > 0.05), and those in the same side manifested dramatic differences between the VCT and VC2 groups (P < 0.01). CONCLUSION: Varicocele induces changes of the NO and IL-1 levels in the testis tissue and increases the apoptosis of spermatogenic cells, which might be one of the causes of testis damage and spermatogenic dysfunction.