Publications (2)2.41 Total impact
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ABSTRACT: Varicocele is the most commonly identifiable, surgically correctable lesion associated with male-factor infertility. Surgical correction of a varicocele, whether unilateral or bilateral, results in improvement not only in semen parameters but also in spontaneous and assisted pregnancy rates. Varicoceles seem to induce a number of changes in the testicular microenvironment. These alterations in temperature, hemodynamics, and reactive oxidative species and antioxidant concentrations have been demon-strated to produce deleterious effects on spermatogenesis. However, despite current knowledge in the patho-physiology of varicocele-associated male infertility, the exact mechanism—or mechanisms—by which varicoceles impair fertility remains elusive. This review examines scientific evidence regarding the pathophysiology of varicocele-associated male infertility.Current Urology Reports 04/2012; 2(6):432-436.
Article: The influence of obstructive interval on patency rates following microsurgical epididymovasostomy.[show abstract] [hide abstract]
ABSTRACT: To determine whether or not obstructive interval (OI) negatively affects patency rates in epididymovasostomy (EV) as a sole procedure alone, we reviewed medical records from obstructive azoospermia (OA) patients who underwent unilateral or bilateral epididymovasostomy. For the purpose of analysis, patients were placed into short OI (15 years or less) or long OI (more than 15 years) categories. Patency rate for the short OI group was 58%, compared to 15% for the long OI group (P<0.01). In conclusion, we observed that patency rates worsened with obstructive interval greater than 15 years. Epididymovasostomy is a challenging procedure that may not be successful, and, thus, patients should be counseled that obstructive interval might affect surgical outcomes. We routinely perform testicular sperm extraction (TESE) with sperm cryopreservation in this patient population due to the high likelihood that it will ultimately be required for assisted reproductive technology (ART).World Journal of Urology 05/2002; 19(6):453-6. · 2.41 Impact Factor