Varicocele repair for low testosterone.

Purpose Of Review: Several recent clinical studies have added to the existing literature on the impact of varicocelectomy on serum testosterone levels. These studies were not included in the most recent previous review of this topic and strengthen considerably the evidence base supporting the claim that varicocele repair can reliably restore below-normal testosterone levels.

Recent Findings: Three studies were published in 2011 on the effect of varicocele repair on testosterone levels.

Review of current varicocelectomy techniques and their outcomes.

Objectives: • To review all the various techniques and their results and efficiencies to provide practicing urologists with some guidance for choice of technique • To discuss improvements of varicocelectomy techniques in the last 15 years and their impact on results of surgery.

Patients And Methods: • A PubMed English literature review of literature from 1995 to present.

Results: • Pregnancy rates were highest with microsurgical subinguinal technique • Varicocele recurrence rates were lowest with microsurgical subinguinal technique • Hydrocele formation rates were lowest with microsurgical inguinal technique • Surgical complications were highest in the laparoscopic technique • Varicocelectomy by itself or in conjunction with IVF is cost effective

Conclusions: • Microsurgical subinguinal or microsurgical inguinal techniques offer best outcomes • Varicocelectomy is a cost effective treatment modality for infertility • Further research is needed to explore new developments in varicocelectomy.

Ejaculatory duct dysfunction and lower urinary tract symptoms: chronic prostatitis.

Chronic pelvic pain syndrome (CPPS) is the most prevalent form of prostatitis. It is characterized by pelvic pain, voiding symptoms, and ejaculatory symptoms in the absence of bacterial infection. This can be a difficult condition to treat.

Rising hypospadias rates: disproving a myth.

Hypospadias is one of the most common congenital abnormalities occurring in males. In recent years, the prevalence of hypospadias and whether that prevalence is rising or stable has become part of a larger debate over the potential effects of so-called 'endocrine disruptors', such as phthalates and bisphenol-A, on male reproductive health. This commentary critically examines allegations suggesting a worldwide increase in hypospadias rates.