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Clues to the Analysis of Testicular Lesions in Infertile Patients with Varicocele

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Clues in the Diagnosis of Non-tumoral Testicular Pathology

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Abstract

In reviewing on the one hand biopsies and surgical specimens of patients with varicocele in the last 40 years, and on the other hand the lesions attributed to the different pathogenetic mechanisms, we have obtained the following results: more than one third of patients with varicocele are carriers of primary lesions (Sertoli cell-only, mixed atrophy, lesions of the basal compartment of the seminiferous tubules), whose severity cannot be explained by any of the pathogenetic mechanisms that have been proposed. Lesions in the adluminal compartment, probably of an obstructive nature, are observed in half the patients with varicocele, secondary to an incomplete obstruction at the mediastinum testis due to a centripetal compression of veins on the rete testis channels. These lesions are not explainable by the mechanisms most commonly referred to in the literature. Heat stress and oxidative stress lesions occur at different levels of spermatogenesis, preferably spermatocytes, spermatids, and spermatozoa aggravating the rest of the described lesions. Histology becomes the most reliable method to detect the preferential type of lesion and its degree and consequently the most important factor for predicting the results of the varicocelectomy.

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Authors and Affiliations

  1. Universidad Autónoma de Madrid (UAM), Department of Anatomy, Histology and Neuroscience, School of Medicine, Madrid, Spain

    Manuel Nistal

  2. School of Medicine, Universidad Autónoma de Madrid (UAM), University Hospital La Paz, Department of Pathology, Madrid, Spain

    Pilar González-Peramato

  3. University Hospital Clinico San Carlos, Department of Urology, Madrid, Spain

    Álvaro Serrano

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  1. Manuel Nistal
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  2. Pilar González-Peramato
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  3. Álvaro Serrano
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Correspondence to Manuel Nistal .

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Nistal, M., González-Peramato, P., Serrano, Á. (2017). Clues to the Analysis of Testicular Lesions in Infertile Patients with Varicocele. In: Clues in the Diagnosis of Non-tumoral Testicular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-49364-0_22

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  • DOI: https://doi.org/10.1007/978-3-319-49364-0_22

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