Abstract / Summary
Abstract Varicocele is characterized by abnormal dilatation of the pampiniform plexus accompanied by venous reflux and is one of the leading correctable causes of male infertility. Although several mechanisms have been proposed, the molecular pathways underlying varicocele-induced testicular dysfunction remain incompletely understood. This study aimed to investigate seminal bradykinin, fetuin-A, pentraxin-3, and adipolin levels in infertile men with varicocele and to compare these biomarkers among patients with varicocele, patients who had undergone varicocelectomy, and controls. This cross-sectional case-control study included 90 participants: 30 infertile men with clinical varicocele, 30 patients who had undergone varicocelectomy and 30 healthy controls. Seminal bradykinin, fetuin-A, pentraxin-3, and adipolin concentrations were determined using ELISA. Sperm concentration, rapid progressive, non-progressive, and immotile sperm percentages, together with bradykinin, fetuin-A, and pentraxin-3 levels, differed significantly among the study groups. Fetuin-A and pentraxin-3 levels were significantly elevated in the varicocele group compared with healthy controls. Patients assessed approximately 3 months after varicocelectomy exhibited significantly higher bradykinin, fetuin-A, and pentraxin-3 levels than controls. No significant differences were observed among the groups regarding age, height, body weight, body mass index, abstinence duration, semen volume, slow progressive sperm percentage, or Adipolin levels. Our findings indicate that patients with varicocele and patients assessed after varicocelectomy exhibit differences in inflammatory and cellular stress-related biomarkers compared with healthy controls. The higher levels of bradykinin, fetuin-A, and pentraxin-3 observed in patients assessed after varicocelectomy may reflect differences in inflammatory and cellular stress-related profiles between the study groups; however, the cross-sectional design does not allow these findings to be interpreted as postoperative persistence or treatment-related changes. These biomarkers may provide complementary information regarding inflammatory and cellular stress-related profiles in varicocele; however, their clinical significance and utility for monitoring postoperative changes require confirmation in larger prospective longitudinal studies.