What is the role of pre-operative blood parameters in forecasting varicocelectomy success?

BACKGROUND: We aimed to examine the effects of pre-operative blood values on varicocelectomy success. MATERIALS AND METHODS: A total of 130 patients who underwent varicocelectomy in our clinic were retrospectively analyzed. Operation success was defined as the return of all semen parameters (concentration, progressive motility, and morphology) to normal values 6 months after surgery. The patients were separated as two groups as benefiting from the treatment (Group A) and not (Group B). RESULTS: The best cut-off value for the neutrophil/lymphocyte ratio (NLR), which can predict varicocelectomy success, was assigned to be 2.27, with AUC of 0.859 (%95 CI 0.795-0.922). The highest sensitivity and specificity were 0.857 and 0.731 (p < 0.001). The best cut-off value for the mean platelet volüme (MPV) value, which can predict varicocelectomy success, was assigned to be 9.45, with AUC of 0.729 (%95 CI 0.639-0.819). The highest sensitivity and specificity were 0.655 and 0.635 (p < 0.001). Binary logistic regression analysis showed NLR ratio (odds ratio (OR): 11.2, p < 0.001) and MPV (OR: 2.65, p = 0.002) parameters as independent predictive factors in predicting varicocelectomy success. DISCUSSION AND CONCLUSION: Our study showed that low NLR ratio (≤2.27) and high MPV (≥9.45) ratio levels may be a useful pre-operative predictive tool in identifying men who benefit most from varicocelectomy in infertile patients with varicocoele.

Paying the price for standing tall: Fluid mechanics of prostate pathology.

BACKGROUND: Age-dependent increase in the incidence of benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are both related to cell proliferation and survival controlled by intraprostatic free testosterone (FT) concentration. Paradoxically, BPH and PCa occur as circulating testosterone levels decrease, so any possible relationship between testosterone levels and development of BPH and PCa remains obscure. RESULTS: In BPH the enlarging prostate is exposed to high testosterone levels arriving directly from the testes at concentrations about hundredfold higher than systemic FT. This occurs because venous blood from the testes is diverted into the prostate due to the elevated hydrostatic pressure of blood in the internal spermatic veins (ISVs). Elevated pressure is caused by the destruction of one-way valves (clinically detected as varicocele), a unique phenomenon related to human erect posture. While standing, human males are ISVs vertically oriented, resulting in high intraluminal hydrostatic pressures-a phenomenon not found in quadrupeds. In this communication, we demonstrate the fluid mechanics' phenomena at the basis of varicocele leading to prostate pathology. CONCLUSIONS: So far, varicocele has been studied mostly for its etiologic role in male infertility and, thus, for its effects on the testes. It is becoming clear that varicocele is a major etiologic factor in BPH and likely also in PCa. Restoring normal testicular venous pressure by treatment of the abnormal ISV's in varicocele has been shown to avert the flow from the prostate with the effect of reducing prostate volume, alleviating symptoms of BPH, and increasing concentrations of circulating FT.

Effect of venous reflux time on testosterone and semen parameters of infertile males after microscopic varicocelectomy.

This study aimed to search whether there is a link between reflux flow and hormonal profile. Data of 250 patients were retrospectively investigated. Pre-operative and 6th month semen analyses of these patients' results were compared with pre-operative and post-operative 6th month serum levels of testosterone. Based on the venous flow on pre-operative Doppler ultrasonography, patients were divided into two groups. Patients with a venous flow ≤4 s were assigned to Group 1 and those with a venous flow >4 s to Group 2. Venous reflux time cut-off was calculated as 4 s using ROC curve according to the increase in testosterone level. When venous reflux time was selected as approximately 4.0 s, ROC had 79.8% sensitivity and 72.8 specificity. The probability of a post-operative increase in testosterone is high in patients with a venous reflux time longer than 4 s.

The predictive value of the platelet volume parameters in evaluation of varicocelectomy outcome in infertile patients.

The aim of this study was to evaluate the role of platelet count (PLT) and platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) as a clinical biomarker in 64 infertile males with varicocele and 45 controls. In addition, semen parameters, serum total testosterone, FSH and testicular volume were measured before and at 6 months after varicocelectomy. The mean PLT, MPV, PDW and PCT were 231 ± 42 × 103/µl, 9.6 ± 1.8 fl, 16.2 ± 2.5 fl and 0.18% in the patient group respectively. When the patient and control groups were compared, there was a significant increase in mean MPV, PDW and PCT (p < .0001), while platelet count was lower in patients than control group, but with no significant relationship. MPV had a significant negative correlation with total testosterone (p < .03). No significant correlations were found between PVI and testicular volume. After follow-up of 37.1 ± 1.9 months, a significant negative correlation was found between the preoperative MPV and varicocelectomy outcome in terms of semen values (p < .007). So, the increase in MPV and low total testosterone in men with varicocele may be a feature of high risk of infertility.

Semen and reproductive hormone parameters in fertile men with and without varicocele.

Although varicoceles are a widely accepted identifiable male factor in infertile couples, the benefit of varicocele repair in improving pregnancy and live birth rates remains uncertain. The Study for Future Families obtained semen and reproductive hormone samples from US men whose partners were currently pregnant. In our analysis cohort of 709 men, a varicocele was detected by clinical examination in 56 (8%) of men. Men with varicocele had smaller left testis, and lower total and total motile sperm counts than men without varicocele. Gonadotropin levels were higher as well in men with varicocele. Interestingly, testosterone levels were also slightly higher in men with varicocele. Despite these differences, there was no difference between the groups in the time to achieve the study pregnancy or percentage of men with a previous pregnancy. We conclude that even in fertile men, varicoceles are associated with some degree of testicular hypofunction. This would support current recommendations to consider varicocele repair in male partners in infertile couples who demonstrate both a varicocele and abnormal semen parameters and after evaluation for treatable female factors.

Increased neutrophil/lymphocyte ratio in testicular cancer.

OBJECTIVE: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. MATERIALS AND METHODS: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). RESULTS: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). CONCLUSIONS: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.

Thiol-disulphide balance in infertility secondary to varicocele.

Oxidative stress plays an important role in the development of infertility secondary to varicocele. We aimed to investigate the dynamic thiol-disulphide homeostasis as an oxidative stress marker in the spermatic vein of infertility secondary to varicocele. Sixty-one patients with varicocele were included in the study. Blood was drawn from the median cubital vein and the testicular venous return side before the spermatic vein was separated during surgery. Total thiol, native thiol, disulphide, ischaemia modified albumin (IMA) and albumin values were measured from both the dilated spermatic vein and the median cubital vein. The disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were determined. The mean age of the patients was 27.0 ± 6.68 (15-50) years. While the albumin, native thiol and total thiol values and the native thiol/total thiol ratio were significantly lower (p = 0.004, p < 0.001, p < 0.001, p < 0.001 respectively), the IMA value and the disulphide/native thiol and disulphide/total thiol ratios were significantly higher (p < 0.001, p < 0.001, p < 0.001 respectively) in the samples taken from spermatic venous blood. Thiol-disulphide balance had deteriorated towards disulphide formation in the spermatic vein compared with the peripheral vein. Abnormal thiol-disulphide balance may be an independent risk factor for infertility secondary to varicocele.

Correlation between Testicular Hemodynamic and Semen Quality Indices in Clinical Varicocele Patients in Pakistan.

Varicocele, a vascular event, is associated with infertility due to testicular damage that causes abnormal spermatogenesis in males. The goal of this study is to ascertain the diagnostic significance of scrotal color Doppler ultrasonography (CDUS) by measuring peak systolic value (PSV) and resistive index (RI) of the arteries supplying blood to the testis and their association with semen quality attributes. Sixty prospective patients (age: 20-50 years) undergoing microsurgical varicocelectomy at a teaching hospital were included in the study. Semen parameters and CDUS were recorded and testicular blood flow was determined as PSV and RI of subcapsular artery and intraparenchymal artery of the testes. Nonparametric statistics was applied to test the correlation/association of the semen quality with the PSV, RI, and other variables. Results revealed a significant negative correlation (r = -0.28; p < 0.05) between progressive motility of spermatozoa and resistive index of the intraparenchymal arterial blood flow. Furthermore, it was noticed that the progressive motility of spermatozoa was tended to be negatively correlated (r = -0.236) with resistive index of subcapsular arterial blood flow. In conclusion, this study has revealed that progressive motility of sperms has correlation with the intraparenchymal blood flow of testes. The progressive motility of sperms could be correlated with RI of testicular blood flow. The apparent lack of association between diameter of varicocele vein and semen quality signifies the need of investigating some other factors that may be involved in pathogenicity of varicocele. The diagnostic value of CDUS may be carefully interpreted and clinically correlated in assessment of severity of varicocele.

The prevalence and severity of varicocele in adult population over the age of forty years old: a cross-sectional study.

Objectives: To investigate the prevalence and severity of varicocele in adult population over the age of 40. We also measured testicular size, consistency, and total testosterone levels with an aim to observe the effect of varicocele on testis as men age. Methods: Two hundred twenty-four patients with varicocele, 241 patients without varicocele who admitted to our clinic were enrolled in the study. We stratified participants by four age groups (40-49, 50-59, 60-69, >70 yr). Patients were grouped according to varicocele grade and laterality. The morning testosterone level was drawn. The subgroups were compared with each other. Results: Overall, varicocele prevalence was 48%. Of the patients, 104 had unilateral, 120 had bilateral varicocele. Of the patients with varicocele, 62 (13.30%) were found as grade 3, 99 (21.10%) were grade 2, and 63 (13.60%) were grade 1. The percentages of smaller testes in grade 1, grade 2, and grade 3 varicocele group were 20.60, 79.80, and 88.70 and a significant association was detected. Age stratification of the data revealed the smaller and soft testis prevalence as well as higher grade varicocele prevalance increased in older age groups. Conclusions: Varicocele presence is associated with lower testicular size, softer testicular consistency, and lower testosterone levels, especially in older patients with bilateral and high-grade varicocele.

Comparison of the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain.

We investigated the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain. We retrospectively reviewed the records of patients who underwent varicocelectomy. The age, body mass index, grade, laterality of varicocele, testicular volume difference, time to hospital visit, serum testosterone level and semen parameters were evaluated. A total of 954 patients were included. The painful group had lower mean age, lower BMI, higher grade of varicocele, smaller testicular volume difference and shorter time to hospital visit than the painless group. In addition, the median serum total testosterone level and total sperm count, concentration and motility were higher in the painful group than in the painless group. In multivariate analysis, there were significant differences between the two groups in age, grade of varicocele, testis volume difference, time to hospital visit, total sperm count and concentration. Patients with painful varicocele visited hospital earlier because of the pain and tended to start treatment sooner. They were also younger, had smaller testis atrophy and had higher sperm concentration, even though they had a higher grade of varicocele than patients without pain. Although scrotal pain in varicocele patients is difficult to treat, it leads to early diagnosis and treatment.

Preoperative neutrophil-to-lymphocyte ratio as a new prognostic predictor after microsurgical subinguinal varicocelectomy.

Various studies have been reported to predict the success of varicocelectomy. Neutrophil-lymphocyte ratio (NLR) is a frequently used indicator of systemic inflammation. We aimed to evaluate the effect of inflammation on the success of varicocelectomy using the NLR. The data of 86 patients who underwent varicocelectomy for infertility were evaluated retrospectively. Pre-operative demographic characteristics of patients, laboratory results such as haemogram, and semen analysis and clinical data were recorded. The semen analysis with the highest total motile sperm count was accepted as pre-operative value. Control was performed with semen analysis at post-operative 6th month. As described in previous studies, in our study, more than 50% increase in total motile sperm count in post-operative semen analysis was defined as a significant improvement. However, at least a 100% increase was required for patients with a total motile sperm count <5 million in the definition of recovery. Patients were divided into two groups as those with improvement in the semen parameters (Group 1) and those without (Group 2). NLR was statistically significantly higher in Group 2 compared with Group 1. The area under the curve (AUC) in the ROC curve for NLR was 0.89. According to the Youden index, the best cut-off value of NLR for varicocelectomy success was 1.98 (sensitivity: 94.7%, specificity: 75.9%, p < 0.001). Logistic regression analysis showed that NLR (odds ratio: 3.6, 95% confidence interval: 1.69-8.38, p < 0.001) is independent predictor factors in predicting the success of varicocelectomy. The results of this study show that systemic inflammation adversely affects the likelihood of improvement in sperm parameters by varicocelectomy. Additionally, NLR has been shown to be an independent factor in the prediction of varicocelectomy success.

Pattern of varicocele vein blood gases in patients undergoing microsurgical Varicocelectomy.

BACKGROUND: Varicocele is known to be associated with infertility and sperm disorders. The exact cause of this ailment is not fully understood. There are limited numbers of studies where venous blood gases (VBGs) of varicocele veins were determined with conflicting results. Therefore, we have investigated the pattern of VBGs in both internal spermatic and external spermatic varicocele veins and correlation with semen quality parameters in infertile individuals who underwent left microsurgical varicocelectomy. METHODS: Patients (n = 27) undergoing left microsurgical varicocelectomy at a tertiary care hospital, were included in the study. Before surgery, semen parameters and scrotal color Doppler ultrasonography was performed. During surgery, blood sample was drawn from varicocele veins (internal spermatic and external spermatic veins) and a peripheral arm vein of the same patient as a control. The VBGs of all veins under study were estimated and compared with each other. The VBGs were also correlated with various semen quality parameters. Data, expressed as Mean ± SD, regarding VBGs in three veins were analyzed using one-way ANOVA. The correlation between VBGs and semen quality parameters was determined using Pearson's correlation. Differences were considered significant at p < 0.05. RESULTS: The pH was found to be higher (p < 0.01) in the internal spermatic vein compared with the external spermatic and the peripheral veins. Partial pressure of oxygen (pO2) and oxygen saturation (sO2) were higher (p < 0.01) in the internal spermatic vein compared with the peripheral vein. However, concentration of bicarbonate (HCO3) was lower (p < 0.01) in both veins compared with the peripheral vein. Partial pressure of carbon dioxide (pCO2) was also lower (p < 0.01) in the varicocele veins compared with the control vein. CONCLUSION: The internal spermatic veins had higher pH and oxygen tension, but lower HCO3 and pCO2 levels compared with the control peripheral veins. External spermatic veins had lower pCO2 and HCO3 but other VBGs were similar to the peripheral veins. The shift of VBGs of internal spermatic vein toward arterial blood pattern may be a missing link to understand the pathophysiology of varicocele.

[Inhibin B level helps evaluate the testicular function of prepubertal patients with varicocele].

OBJECTIVE: To investigate the role of the serum inhibin B (INHB) level in evaluating the testicular function of the prepubertal patient with varicocele (VC) after high ligation of the spermatic vein (HLSV). METHODS: This study included 31 prepubertal male patients with left VC, averaging 12.55 years of age and 9 complicated by right VC. We collected peripheral blood samples before and at 4, 12 and 26 weeks after HLSV as well as spermatic venous blood samples intraoperatively for determination of the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), anti-sperm antibody (AsAb) and serum INHB by ELISA. RESULTS: Compared with the baseline, statistically significant differences were observed in the INHB level in the peripheral blood at 12 and 26 weeks after operation (ï¼»255.18 ± 69.97ï¼½ vs ï¼»141.78 ± 59.82ï¼½ pg/ml, P < 0.05) and that in the spermatic venous blood intraoperatively (ï¼»255.18 ± 69.97ï¼½ vs ï¼»412.44 ± 259.42ï¼½ pg/ml, P < 0.01). Spearman's analysis showed a negative correlation between the level of INHB and that of FSH (r = －0.224, P < 0.01). CONCLUSIONS: The level of serum INHB in the peripheral blood of the prepubertal VC patient is decreased within 6 months after HLSV and negatively correlated with that of FSH. The levels of INHB and FSH may well reflect the testicular function of the prepubertal VC patient.

[Serum inhibin B and varicocele: An update].

Inhibin B, a glycoprotein produced predominantly by Sertoli cells and preferentially suppressing the production and secretion of follicle-stimulating hormone (FSH) in the pituitary, is closely related to spermatogenesis. Varicocele is the abnormal dilatation and tortuosity of the pampiniform plexus veins, which may contribute to spermatogenic dysfunction and male infertility. More and more evidence has shown that the level of serum inhibin B is negatively correlated with the severity of varicocele. Determination of the inhibin B level may help assess the severity of spermatogenic dysfunction of the patient and predict the outcomes of varicocele repair and therefore has a potential application value in the diagnosis and treatment of varicocele.

Effect of ghrelin on the biochemical and histopathology parameters and spermatogenesis cycle following experimental varicocele in rat.

BACKGROUND: Varicocele is one of the major causes of infertility in men in which testicular function is progressively damaged. OBJECTIVES: This study aimed to determine the effect of ghrelin on antioxidant enzymes activity (catalase, SOD, GPx), malondialdehyde (MDA) level and spermatogenesis cycle after induction of varicocele in rat. MATERIALS AND METHODS: Twenty-one male Wistar rats were randomly divided into three groups: I-control group, II-rats with induced varicocele and injection of physiological saline and III-rats with induced varicocele and injection of ghrelin. At the end of the experiment, animals were sacrificed and their testes were removed. Antioxidant enzymes activity and MDA level were measured. Histopathological tests, Johnsen's score and sperm parameters were also evaluated. RESULTS: In varicocele group with ghrelin administration (group III), the levels of SOD (0.183 ± 0.024), GPX (9.4250 ± 0.103) and TAC (2.79 ± 0.464) increased significantly (p < 0.05), while MDA (0.304 ± 0.004) level decreased significantly (p < 0.05) compared with varicocele and normal saline group (II). There was no significant difference in the activity of catalase between group III (0.122 ± 0.018) and group II (0.108 ± 0.018), although ghrelin improved catalase activity in group III compared to group II. Also, in group III, there were significant increases in the Johnsen's score (7.920), sperm count (70.29 ± 5.82) and sperm viability (87.14 ± 5.21) compared with group II (p < 0.05). CONCLUSION: Ghrelin can improve the capacity of antioxidant enzymes to reduce the oxidative stress caused by varicocele and reduce spermatogenesis cycle. Therefore, special attention should be paid to ghrelin in studies evaluating antioxidant compounds in varicocele.

Fate of Recurrent or Persistent Varicocele in the Era of Assisted Reproduction Technology: Microsurgical Subinguinal Redo Varicocelectomy Versus Observation.

OBJECTIVE: To compare sperm parameters, serum hormone levels, and pregnancy and miscarriage rates between the infertile men with recurrent or persistent varicocele who underwent microsurgical subinguinal redo varicocelectomy or had observation only. MATERIALS AND METHODS: The study included 217 primary infertile men with recurrent or persistent varicocele. The patients were divided into 2 groups: 120 men underwent microsurgical subinguinal redo varicocelectomy, and 97 had observation only. Differences in total motile sperm count and serum hormone levels, and pregnancy and miscarriage rates were compared between the 2 groups. RESULTS: The mean total motile sperm count increased from 20.93 ± 2.87 to 45.54 ± 6.28 million in the microsurgical redo varicocelectomy group, and decreased from 16.62 ± 2.75 to 15.6 ± 2.81 million in the control group, revealing significant difference between the 2 groups (P = .000). Increase in total testosterone level was significantly higher in the microsurgical redo varicocelectomy group (+1.36 ± 0.32 ng/mL) than in the control group (-0.23 ± 0.1 ng/mL) (P = .000). Of the couples, 63 achieved pregnancy in the microsurgical redo varicocelectomy group (52.5%), and 38 had pregnancy in the control group (39.2%) (P <.05). Spontaneous pregnancy rate was significantly higher in the microsurgical redo varicocelectomy group (39.7%) than in the control group (15.8%) (P <.01). Use of assisted reproductive technology to achieve pregnancy was significantly lower in the microsurgical redo varicocelectomy group (60.3%) than in the control group (84.2%) (P <.01). CONCLUSION: Microsurgical subinguinal redo varicocele repair improves postoperative sperm parameters, serum total testosterone level, and spontaneous pregnancy rates compared with the controls. It also decreases need for use and level of assisted reproductive technology.

Impact of Subinguinal Varicocelectomy on Serum Testosterone to Estradiol Ratio in Male Patients With Infertility.

OBJECTIVE: To assess the effect of varicocele and subsequent varicocelectomy on testosterone-estradiol ratio in patients presented with infertility or testicular pain. MATERIALS AND METHODS: In this prospective, controlled, clinical study, 135 men were assigned to 3 equal groups (n = 45 per group). The varicocele-treated "varicocelectomy" group included patients with varicocele who underwent loupe-assisted subinguinal varicocelectomy for infertility or testicular pain; the varicocele-not-treated "positive control" group included patients with varicocele who refused or who wished to postpone varicocelectomy; and the no-varicocele "negative control" group included fertile men without varicocele. The varicocele-treated patients underwent loupe-assisted subinguinal varicocelectomy for infertility or testicular pain. Semen analysis, serum testosterone, estradiol, follicle stimulating hormone, luteinizing hormone, prolactin, calculation of testosterone to estradiol ratio (T:E ratio), and scrotal Doppler ultrasound were assessed at baseline and 6 months later. RESULTS: Total testosterone levels and T:E ratio were in the normal range in all groups. Men with varicocele had significantly lower levels of total testosterone and T:E ratio than men without varicocele (P <.001 for each). Testosterone levels were 4.9, 4.6, and 7.3 ng/mL, and T:E ratios were 19, 17.4, and 28.1 in the treated, positive, and negative control groups, respectively. Testosterone level and T:E ratio were significantly higher in the negative control group than the other 2 groups at baseline assessment (P <.001 for each). These parameters improved significantly 6 months after varicocelectomy in the treated group; whereas, they remained unchanged in the 2 control groups. CONCLUSION: Varicocele is associated with the diminishing of total testosterone and T:E ratio, which were significantly improved after subsequent subinguinal varicocelectomy.

Varicocele is the root cause of BPH: Destruction of the valves in the spermatic veins produces elevated pressure which diverts undiluted testosterone directly from the testes to the prostate.

In varicocele, there is venous flow of free testosterone (FT) directly from the testes into the prostate. Intraprostatic FT accelerates prostate cell production and prolongs cell lifespan, leading to the development of BPH. We show that in a large group of patients presenting with BPH, bilateral varicocele is found in all patients. A total of 901 patients being treated for BPH were evaluated for varicocele. Three diagnostic methods were used as follows: physical examination, colour flow Doppler ultrasound and contact liquid crystal thermography. Bilateral varicocele was found in all 901 patients by at least one of three diagnostic methods. Of those subsequently treated by sclerotherapy, prostate volume was reduced in more than 80%, with prostate symptoms improved. A straightforward pathophysiologic connection exists between bilateral varicocele and BPH. The failure of the one-way valves in the internal spermatic veins leads to a cascade of phenomena that are unique to humans, a result of upright posture. The prostate is subjected to an anomalous venous supply of undiluted, bioactive free testosterone. FT, the obligate control hormone of prostate cells, reaches the prostate directly via the venous drainage system in high concentrations, accelerating the rate of cell production and lengthening cell lifespan, resulting in BPH.

Roles of Fas/FasL-mediated apoptosis and inhibin B in the testicular dysfunction of rats with left-side varicocele.

We investigated the role of the Fas/FasL signalling pathway and inhibin B expression in rats with an experimentally induced left-side varicocele. Forty-five Sprague Dawley (SD) male rats were randomly divided into three groups in average: control group, sham group and experimental group. The expression of inhibin B in the rat left testis was analysed at the mRNA and protein levels by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting respectively. The expressions of Fas, FasL and caspase-3 in the left testis were measured by RT-PCR and immunofluorescence. The apoptosis index (AI) was measured by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Both the mRNA and protein of inhibin B were significantly reduced in the experimental group compared with that in the control group or the sham group. The expression of Fas, FasL and caspase-3 in the experimental group was significantly increased compared to that in the control group or the sham group. The concentration of serum inhibin B was also inversely related to circulating FSH concentrations and positively correlated with sperm count. It is concluded that Fas/FasL system may play an important role in apoptosis of rats with experimental varicocele and inhibin B could reflect spermatogenesis function.