ABSTRACT
PURPOSE: This study evaluated the relationships of varicocele characteristics and surgical methods with the pain resolution rate post-varicocelectomy. MATERIALS AND METHODS: A literature search was conducted using PubMed (MEDLINE) and Embase (1980 to December 2018). The keywords used for the search were "varicocele," "varicocelectomy OR ligation OR repair," and "pain OR painful." Two authors independently reviewed the titles and abstracts of the retrieved articles. Studies were evaluated for eligibility, and those that fulfilled all of the inclusion criteria and none of the exclusion criteria were selected for full-text review. RESULTS: Fourteen studies were included in the analysis. There were no significant differences in the postoperative pain resolution rate with respect to varicocele grades I, II, and III. The resolution rate was significantly higher for dull pain than for dragging and sharp pain (odds ratio [OR], 5.73; 95% confidence interval [CI], 1.78-18.41; p=0.003 and OR, 8.72; 95% CI, 2.91-26.08; p=0.0001, respectively). In terms of the surgical approach, subinguinal ligation was significantly more effective in terms of pain resolution than high ligation (OR, 2.73; 95% CI, 1.54-4.85; p=0.0006). Microsurgical varicocelectomy showed a significantly higher likelihood of pain resolution than laparoscopic varicocelectomy (OR, 7.12; 95% CI, 3.78-13.44; p<0.0001). CONCLUSIONS: Patients with varicocele complaining of dull pain preoperatively had a higher likelihood of postoperative pain resolution than those complaining of dragging or sharp pain. Furthermore, subinguinal ligation was more effective for pain resolution than high ligation, and microsurgical varicocelectomy showed better surgical outcomes than laparoscopic varicocelectomy.
ABSTRACT
Purpose: This study aimed to evaluate the clinical efficacy of a portable smartphone-based system for computer-assisted semen analysis (CASA) compared with the results of manual microscopic semen analysis (SA) and laboratory-based CASA for self-evaluation of semen parameters by a male partner. Materials and Methods: From July 2017 to February 2018, a total of 28 samples were analyzed for concentration and motility with a smartphone-based CASA system and the results compared with those from laboratory-based CASA and manual microscopic SA with a Makler Counting Chamber (SEFI Medical Instruments, Israel). Results: Sperm concentration and motility measured with the smartphone-based CASA system were positively correlated with the microscopic-based results. Likewise, sperm motility calculated with smartphone-based CASA was positively correlated with the laboratory-based CASA results. These results suggest that the smartphone-based CASA system can be used for clinical semen diagnosis. Conclusions: A portable smartphone-based CASA system can play a role in motivating infertile males to visit clinics, thus resulting in early diagnosis and treatment with cost-effectiveness. The device can be used for easy follow-up on a screening basis by the male partner before visiting a clinic for fertility evaluation or by infertile males after receiving medical management. Additionally, future software advancements and post-marketing consumer surveys will make possible wider applications, including assessment of sperm morphology, in the coming future.
