ORIGINAL ARTICLE
Is there any relationship between mean platelet volume and varicocele? € u _ Kelesß2, I. _ Bıyık3, M. Gu lu1, T. Ozg € zelsoy1, A. R. Tu € rkog € nay1 & N. Ocak4 S. C ß oban1, I. 1 2 3 4
Department Department Department Department
of of of of
Urology, Sßevket Yılmaz Training and Research Hospital, Bursa, Turkey; Urology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey; Obstetrics and Gynecology, Karacabey State Hospital, Bursa, Turkey; Biochemistry, Sßevket Yılmaz Training and Research Hospital, Bursa, Turkey
Keywords Mean platelet volume—varicocele Correspondence Soner C ß oban, Department of Urology, Sevket Yilmaz Education and Training Hospital, 16260, Yildirim, Bursa, Turkey. Tel.: 0090 (224) 295 52 90; Fax: 0090 (224) 294 44 99; E-mail: [email protected] Accepted: November 14, 2013 doi: 10.1111/and.12220
Summary Mean platelet volume (MPV) is a parameter that is obtained from an automatic haemogram device during routine blood count and measures platelet reactivity. Increased platelet volume has been considered to be a risk factor for vascular diseases. The aim of this study was to evaluate the relationship between the presence of varicocele and the MPV, platelet count (PLT) and platelet distribution width (PDW) values. We included 264 patients with a diagnosis of varicocele in Group 1, and 220 patients with no varicocele in Group 2. The varicocele diagnosis was performed both with physical examination findings and colour Doppler ultrasonography (CDU). Mean platelet volume values were statistically significantly high (P < 0.001) whereas PLT and PDW values were statistically significantly low (P = 0.011), (P = 0.008) in the varicocele group compared with the control group respectively. However, no significant correlation was found between MPV and PDW in patients diagnosed with varicocele and the varicocele grade on examination and spermatic vein diameter on CDU. Mean platelet volume, which is used widely to measure the size of platelets and indicates platelet reactivity, can provide guidance in the investigation of varicocele pathophysiology and the relevant vascular pathologies.
Introduction Varicocele is an often asymptomatic disorder characterised by abnormal dilatations in the testicular vein and pampiniform plexus due to valvular insufficiency in the spermatic cord caused by various aetiological factors (Kocakoc et al., 2003). The incidence of varicocele in the general population is 6–23% and was approximately 15% in a very large series (Meacham et al., 1994). The rate is around 35% in men presenting with primary infertility (Gorelick & Goldstein, 1993). Although there are many studies on the aetiopathogenesis, it has not been fully elucidated. Varicocele has been proven to be associated with other vascular pathologies (Androulakis et al., 2004). Yetkin et al. (2005) reported a high prevalence of varicocele in patients with coronary artery ectasia. Kilicß et al. (2007) also reported peripheral varicose veins to have a common pathological mechanism with varicocele. © 2014 Blackwell Verlag GmbH Andrologia 2015, 47, 37–41
Mean platelet volume is a parameter that is obtained from an automatic haemogram device during routine blood count and measures platelet reactivity. Many disorders have been shown to be associated with abnormalities in mean platelet volume. The increased platelet volume in Bernard–Soulier syndrome is pathognomonic (Jackson & Carter, 1993). Platelet volume has been found to be associated with platelet function and activation (Cameron et al., 1983). Increased platelet volume has been accepted as an independent risk factor in coronary artery diseases and cerebrovascular disorders in large studies (Khode et al., 2012). Although there are studies on the relationship between mean platelet volume (MPV) and vascular diseases in the literature, there are limited studies investigating the relationship between MPV and varicocele. The aim of this study was to investigate the relationship between varicocele, characterised by abnormal enlargement of 37
Mean platelet volume relation to varicocele
the scrotal veins, and MPV, a predictor of vascular pathology. Materials and methods Study design The data of a total of 484 patients who had been evaluated with a preliminary diagnosis of varicocele at the Sßevket Yılmaz Training and Research Hospital’s urology outpatient department between November 2010 and March 2013 were retrospectively analysed. Ethics approval was obtained from our institutional review board. Among the 264 subjects enrolled into the study, 254 had infertility- and 10 had noninfertility-related (pain, cosmetic concerns) complaints. The ages of the patients varied between 12 and 48 years. Group 1 included 264 patients with a diagnosis of varicocele, and Group 2 included 220 patients with no varicocele. The control group was selected among consecutive age-matched male patients without varicoceles. The same exclusion criteria were also used. History, physical examination, colour Doppler ultrasonography (CDU), haemoglobin, white blood cell (WBC), mean erythrocyte volume (MCV), platelet (PLT), MPV and platelet distribution width (PDW), results were obtained from the charts of the patients with varicocele. Varicocele was diagnosed essentially by physical examination. However, Doppler ultrasonography was routinely performed in all patients to confirm the diagnosis and for research purposes. Varicocele was grouped as mild (Grade I: varicose veins are palpable only during the Valsalva manoeuvre), moderate (Grade II: varicose veins may be palpable during rest but not visible) or severe (Grade III: visible varicose veins) in the affected patients.
S. C ß oban et al.
Statistical analysis was performed with SPSS, version 15.0 (SPSS, Inc., Chicago, IL, USA) software. Compliance of variables with a normal distribution was analysed with visual methods (histogram and probability plots) and analytical methods (the Kolmogorov–Smirnov test). Descriptive analyses were provided as mean and standard deviation. Comparisons between groups were performed with the Mann–Whitney U-test and correlation between variables with the Spearman’s analysis. The results were accepted as statistically significant when P was
Is there any relationship between mean platelet volume and varicocele? € u _ Kelesß2, I. _ Bıyık3, M. Gu lu1, T. Ozg € zelsoy1, A. R. Tu € rkog € nay1 & N. Ocak4 S. C ß oban1, I. 1 2 3 4
Department Department Department Department
of of of of
Urology, Sßevket Yılmaz Training and Research Hospital, Bursa, Turkey; Urology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey; Obstetrics and Gynecology, Karacabey State Hospital, Bursa, Turkey; Biochemistry, Sßevket Yılmaz Training and Research Hospital, Bursa, Turkey
Keywords Mean platelet volume—varicocele Correspondence Soner C ß oban, Department of Urology, Sevket Yilmaz Education and Training Hospital, 16260, Yildirim, Bursa, Turkey. Tel.: 0090 (224) 295 52 90; Fax: 0090 (224) 294 44 99; E-mail: [email protected] Accepted: November 14, 2013 doi: 10.1111/and.12220
Summary Mean platelet volume (MPV) is a parameter that is obtained from an automatic haemogram device during routine blood count and measures platelet reactivity. Increased platelet volume has been considered to be a risk factor for vascular diseases. The aim of this study was to evaluate the relationship between the presence of varicocele and the MPV, platelet count (PLT) and platelet distribution width (PDW) values. We included 264 patients with a diagnosis of varicocele in Group 1, and 220 patients with no varicocele in Group 2. The varicocele diagnosis was performed both with physical examination findings and colour Doppler ultrasonography (CDU). Mean platelet volume values were statistically significantly high (P < 0.001) whereas PLT and PDW values were statistically significantly low (P = 0.011), (P = 0.008) in the varicocele group compared with the control group respectively. However, no significant correlation was found between MPV and PDW in patients diagnosed with varicocele and the varicocele grade on examination and spermatic vein diameter on CDU. Mean platelet volume, which is used widely to measure the size of platelets and indicates platelet reactivity, can provide guidance in the investigation of varicocele pathophysiology and the relevant vascular pathologies.
Introduction Varicocele is an often asymptomatic disorder characterised by abnormal dilatations in the testicular vein and pampiniform plexus due to valvular insufficiency in the spermatic cord caused by various aetiological factors (Kocakoc et al., 2003). The incidence of varicocele in the general population is 6–23% and was approximately 15% in a very large series (Meacham et al., 1994). The rate is around 35% in men presenting with primary infertility (Gorelick & Goldstein, 1993). Although there are many studies on the aetiopathogenesis, it has not been fully elucidated. Varicocele has been proven to be associated with other vascular pathologies (Androulakis et al., 2004). Yetkin et al. (2005) reported a high prevalence of varicocele in patients with coronary artery ectasia. Kilicß et al. (2007) also reported peripheral varicose veins to have a common pathological mechanism with varicocele. © 2014 Blackwell Verlag GmbH Andrologia 2015, 47, 37–41
Mean platelet volume is a parameter that is obtained from an automatic haemogram device during routine blood count and measures platelet reactivity. Many disorders have been shown to be associated with abnormalities in mean platelet volume. The increased platelet volume in Bernard–Soulier syndrome is pathognomonic (Jackson & Carter, 1993). Platelet volume has been found to be associated with platelet function and activation (Cameron et al., 1983). Increased platelet volume has been accepted as an independent risk factor in coronary artery diseases and cerebrovascular disorders in large studies (Khode et al., 2012). Although there are studies on the relationship between mean platelet volume (MPV) and vascular diseases in the literature, there are limited studies investigating the relationship between MPV and varicocele. The aim of this study was to investigate the relationship between varicocele, characterised by abnormal enlargement of 37
Mean platelet volume relation to varicocele
the scrotal veins, and MPV, a predictor of vascular pathology. Materials and methods Study design The data of a total of 484 patients who had been evaluated with a preliminary diagnosis of varicocele at the Sßevket Yılmaz Training and Research Hospital’s urology outpatient department between November 2010 and March 2013 were retrospectively analysed. Ethics approval was obtained from our institutional review board. Among the 264 subjects enrolled into the study, 254 had infertility- and 10 had noninfertility-related (pain, cosmetic concerns) complaints. The ages of the patients varied between 12 and 48 years. Group 1 included 264 patients with a diagnosis of varicocele, and Group 2 included 220 patients with no varicocele. The control group was selected among consecutive age-matched male patients without varicoceles. The same exclusion criteria were also used. History, physical examination, colour Doppler ultrasonography (CDU), haemoglobin, white blood cell (WBC), mean erythrocyte volume (MCV), platelet (PLT), MPV and platelet distribution width (PDW), results were obtained from the charts of the patients with varicocele. Varicocele was diagnosed essentially by physical examination. However, Doppler ultrasonography was routinely performed in all patients to confirm the diagnosis and for research purposes. Varicocele was grouped as mild (Grade I: varicose veins are palpable only during the Valsalva manoeuvre), moderate (Grade II: varicose veins may be palpable during rest but not visible) or severe (Grade III: visible varicose veins) in the affected patients.
S. C ß oban et al.
Statistical analysis was performed with SPSS, version 15.0 (SPSS, Inc., Chicago, IL, USA) software. Compliance of variables with a normal distribution was analysed with visual methods (histogram and probability plots) and analytical methods (the Kolmogorov–Smirnov test). Descriptive analyses were provided as mean and standard deviation. Comparisons between groups were performed with the Mann–Whitney U-test and correlation between variables with the Spearman’s analysis. The results were accepted as statistically significant when P was
