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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTEIXEIRA, Thiago Afonso
dc.contributor.authorPARIZ, Juliana Risso
dc.contributor.authorDUTRA, Robertson Torres
dc.contributor.authorSALDIVA, Paulo Hilario
dc.contributor.authorCOSTA, Elaine
dc.contributor.authorHALLAK, Jorge
dc.identifier.citationTRANSLATIONAL ANDROLOGY AND UROLOGY, v.8, n.4, p.346-355, 2019
dc.description.abstractBackground: It remains challenging to determine which individuals are likely to benefit from microsurgical correction of subclinical varicocele, as basic semen parameters often do not improve postoperatively. We aimed to develop an easily accessible tool for prognostic stratification of infertile men indicated for microsurgical correction of bilateral subclinical varicocele characterized by prolonged and clear venous reflux and no other cause for infertility. Methods: We retrospectively analyzed the testicular biopsy, seminal analysis, and ultrasound evaluation records of 20 men managed between 2006 and 2014. Subclinical varicocele was diagnosed through bilateral testicular palpation and auscultation of venous reflux using a Doppler stethoscope, with confirmation on color Doppler sonography. We conducted receiver operating characteristic curve analysis to identify the optimal combinations of cut-offs for the Johnsen score, Copenhagen index, and testicular volume defining histological patterns with positive prognostic value for improved postoperatively reproductive capacity. Results: Positive prognostic value was noted for the following combinations of parameters: (I) Johnsen score >8.2 in the left testicle and right testicular volume >12.8 mL predicted improved sperm concentration; (II) Johnsen score >8.2 and Copenhagen index digit II <2.5 bilaterally predicted improved total sperm motility; (III) Johnsen score >9.1 and Copenhagen index digit III <1.5 bilaterally predicted improved progressive sperm motility; (IV) Johnsen score >7.9 and right testicular volume >13.6 mL predicted improved sperm morphology. Conclusions: Johnsen score and Copenhagen index as histopathological prognostic factors can be easily obtained upon evaluation of testicular biopsy specimens and can be simple and reliable tool to establish a more realistic prognosis for reproductive capacity in men who undergo microsurgical correction of subclinical varicocele with no other detectable cause for infertility.eng
dc.publisherAME PUBL COeng
dc.relation.ispartofTranslational Andrology and Urology
dc.subjectTesticular biopsyeng
dc.subjectsubclinical varicoceleeng
dc.subjectseminal parameterseng
dc.subjectmale infertilityeng
dc.subject.othertesticular biopsyeng
dc.titleCut-off values of the Johnsen score and Copenhagen index as histopathological prognostic factors for postoperative semen quality in selected infertile patients undergoing microsurgical correction of bilateral subclinical varicoceleeng
dc.rights.holderCopyright AME PUBL COeng
dc.subject.wosUrology & Nephrologyeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Robertson Torres:Univ Sao Paulo, Inst Adv Studies, Div Urol, Sao Paulo, Brazil; Univ Sao Paulo, Dept Pathol, Reprod Toxicol Unit, Sao Paulo, Brazil, Elaine:Univ Sao Paulo, Inst Adv Studies, Mens Hlth Study Grp, Sao Paulo, Brazil; Androsci Sci & Innovat Ctr, Oaqu Floriano St,533 Cj 9 4, BR-04534011 Sao Paulo, SP, Brazil; Androsci Sci & Innovat Ctr, High Complex Clin & Res Androl Lab, Oaqu Floriano St,533 Cj 9 4, BR-04534011 Sao Paulo, SP, Brazil; Univ Sao Paulo, Div Endocrinol, Sao Paulo, Brazil
hcfmusp.publisher.countryPEOPLES R CHINAeng
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Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/05
LIM/05 - Laboratório de Poluição Atmosférica Experimental

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