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    Impact of Varicocele on Testicular Oxidative Stress and Sperm Parameters in Experimental Animals: A Systematic Review and Meta-Analysis
    (Korean Soc Sexual Medicine & Andrology, 2024) Russo, Giorgio Ivan; Saleh, Ramadan; Finocchi, Federica; Juma, Almas Ramadhani; Durairajanayagam, Damayanthi; Kahraman, Oguzhan; Sogutdelen, Emrullah
    Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause -effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta -analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele. Materials and Methods: A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (x106), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist. Results: Out of 76 identified articles, 6 studies on rats were included in the meta -analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high. Conclusions: This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
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    Minimally invasive renal transplantation
    (Nova Science Publishers, Inc., 2023) Sogutdelen, Emrullah; Kemahli, Eray; Sener, Alp
    The prevalence of CKD has become a major health concern, affecting 1 in 7 (14%) people in the United States. Additionally, CKD is increasing globally due to the aging of the population and an increase in chronic diseases such as hypertension and diabetes. In 2019, more than 150,000 solid organ transplants were performed worldwide, of which over 60% were kidney transplants. This chapter will focus mostly on the use and increasing importance of minimally invasive methods (laparoscopy and robotics) in kidney transplantation. The increase in the number and long term success of kidney transplants in the light of immunological, pathological, and pharmacological developments over the years. As minimally invasive techniques were improved across multiple surgical disciplines, these methods began to be used for the first time in donor nephrectomies; the first reports highlighting laparoscopic and robotic-assisted laparoscopic donor nephrectomies were performed by Ratner at Johns Hopkins University in 1995 and by Horgan at the University of Illinois, Chicago, in 2000, respectively. The most important parameter in kidney transplantation is patient and graft survival. Cross-matching, preemptive transplantation, short ischemia and anastomotic times, and grafts obtained from living donors all have an impact on graft survival. Patient and graft survival are similar in both conventional open and minimally invasive transplant models. The goal of minimally invasive surgery has always been to minimize surgical trauma and related complications such as postoperative pain, wound-related complications, and cosmetic side effects by using optical and electronic visualization equipment with several small incisions instead of a single large incision. In addition, enhanced imaging allows the surgical field and structural anatomy to be more clearly visualized. However, there are some limitations such as expensive imaging equipment, lack of tactile feedback, and steep learning curves that come up with novel technologies. Robot-assisted laparoscopic surgery partially removes the technical limitations of laparoscopy. This innovation has significantly expanded the indication for minimally invasive surgery in more sensitive and complex surgeries, thanks to its advantages such as higher resolution and 3D imaging, greater motion sensitivity, improved dexterity, and tremor filtration. © 2023 Nova Science Publishers, Inc. All rights reseverd.