Mathematical Modelling of Aorto-Mesenteric "Tweezers", Affecting the Relationship Between Dehydroepiandrostenedione and Testosterone in Persons with Varicocele

Authors

  • Tonyan A.G. Multidisciplinary Medical Center "City Clinic", Krasnodar, Российская Федерация
  • Tatevosyan A.S. Kuban State Medical University, Krasnodar, Российская Федерация
  • Bunyakin A.V. Kuban State University, Krasnodar, Российская Федерация

UDC

532

DOI:

https://doi.org/10.31429/vestnik-17-1-2-81-91

Abstract

The purpose of the study. Study the influence of venous blood flow in the left renal vein pool on the activity of adrenal cortex hormones and testosterone level in patients with varicocele.

Methods of research. Blood flow evaluation was performed in six static states according to the difference between the maximum and minimum velocity ($\Delta V_\text{ven}$) in the left renal vein (PV): on the back, on the abdomen, on the right side, on the left side, sitting and standing. Infringement of a blood flow was fixed at $\Delta V_\text{ven}$ more than 20 cm/s. In the position of minimum and maximum $\Delta V_\text{ven}$ in the morning at 8 o'clock on the empty stomach, blood was taken from the cubital vein at 3–5 minutes’ intervals (until the patient turns from one position to another) to dehydroepiandrostenedione (DHEA) and total testosterone (T) with two inputs to the vein. A visual assessment was made of the relationship between DHEA and T when patients moved from a position with a minimum $\Delta V_\text{ven}$ to a position with a maximum $\Delta V_\text{ven}$.

Results of the study. Estimating the relationship between DHEA and T, we estimated the ups or downs of these indicators when moving from a position with a minimum $\Delta V_\text{ven}$ to a position with a maximum $\Delta V_\text{ven}$. It turned out that T can both increase and decrease with increasing and lowering the level of DHEA. In one case, with an increase in DHEA, the testosterone level did not change.

Discussion. To simulate (for the purpose of approximate numerical description) of blood flow processes, an analogy is given with the nonstationary flow of a compressible medium in a pipe of constant diameter using the continuity (in the form of Euler). The left renal vein, due to its topographic and anatomical features (lability), can considered as an "object of control, and tweezers as a controlling organ", that is, indicators such as velocity, diameter and pressure are not constant in it, which determines the variety of DHEA relationships and T.

Conclusions. Aorto-methangent "tweezers" can be considered as a pressure controller in the "pool" of the left renal vein, which includes the adrenal and testicular veins. The relationship between DHEA and T is variable and requires further study.

Keywords:

varicocele, blood flow, dehydroepiandrostenedione, testosterone, interrelations

Author Infos

Arsen G. Tonyan

канд. мед. наук, врач-уролог многопрофильного медицинского центра "Сити Клиник"

e-mail: tonyanag@rambler.ru

Artur S. Tatevosyan

д-р мед. наук, профессор кафедры урологии Кубанского государственного медицинского университета

e-mail: artur-krasnodar@bk.ru

Aleksey V. Bunyakin

канд. физ.–мат. наук, доцент кафедр математических и компьютерных методов Кубанского государственного университета

e-mail: alex.bunyakin@mail.ru

References

  1. Ivanissevich, O. Left varicocele due to reflux. Experience with 4470 operative cases in forty-two years. J. Int. Coll. Surg., 1960, vol. 34. iss. 12, pp. 742–755.
  2. Coolsaet, B.L. The varicocele syndrome: venography determining the optimal level for surgical management. J. Urol., 1980, vol. 124, pp. 833–839.
  3. Severgina, E.S., Severgina, L.O., Rapoport, L.M., Rapoport, Yu.L., Derunova, T.I. Remodelirovanie sosudov kak proyavlenie kompensatornykh protsessov pri varikotsele raznoy stepeni vyrazhennosti [Vascular remodeling as a manifestation of compensatory processes with varicocele of varying severity]. Andrologiya i genital'naya khirurgiya [Andrology and Genital Surgery], 2013, no. 2, pp. 35–39. DOI: 10.17650/2070-9781-2013-2-35-39 (In Russian)
  4. Loran, O.B., Gagarina, S.V., Stoyko, Yu.M., Sokolytsik, M.M., Golitsyn, A.V. Vybor metoda khirurgicheskoy korrektsii varikotsele s uchetom osobennostey venoznoy gemodinamiki [Choice of surgical correction method for varicocele taking into account the peculiarities of venous hemodynamics]. Urologiya [Urology], 2006, no. 5, pp. 24–30. (In Russian)
  5. Vinogradov, I.V., Protasov, A.V., Abazova, M.Kh., Bogdanov, D.Yu. Primenenie endoskopicheskogo klipirovaniya yaichkovoy veny v zabryushinnom prostranstve v lechenii varikotsele, oslozhnennogo patospermiey i besplodiem [The use of endoscopic clipping of the testicular vein in the retroperitoneal space in the treatment of varicocele complicated by pathospermia and infertility]. Endoskopicheskaya khirurgiya [Endoscopic Surgery], 2008, no. 6, pp. 48–50. (In Russian)
  6. Latyshev, A.V., Davydov, A.A., Chepurov, D.A., Tazhetdinov, O.Kh. Sravnitel'naya otsenka laparoskopicheskogo klipirovaniya yaichkovoy veny i operatsii Marmara pri varikotsele [Comparative evaluation of laparoscopic clipping of the testicular vein and Marmara’s surgery for varicocele]. Kremlevskaya meditsina [Kremlin Medicine], 2009, no. 2, pp. 10–12. (In Russian)
  7. Mazo, E.B., Koryakin, M.V., Evseev, L.P., Akopyan, A.S. Rol' funktsional'noy vzaimosvyazi nadpochechnikov i yaichek v patogeneze besplodiya u bol'nykh s levostoronnim varikotsele [The role of the functional relationship of the adrenal glands and testes in the pathogenesis of infertility in patients with left-sided varicocele]. Urologiya i nefrologiya [Urology and Nephrology], 1990, no. 2, pp. 50–58. (In Russian)
  8. Henriksson ,C., Haraldsson, G., Aldenborg, F., Lindberg, S., Pettersson, S. Skeletal metastases in 102 patients evaluated before surgery for renal cell carcinoma. Scand. J. Urol. Nephrol., 1992, vol. 26, pp. 363–369. DOI: 10.3109/00365599209181227
  9. Mazo, E.B., Koryakin, M.V. Novoe v lechenii muzhskogo besplodiya pri varikotsele [New in the treatment of male infertility with varicocele]. Meditsina, Moscow, 1992. (In Russian)
  10. Warren, K.S., McFarlane, J. The Bosniak classification system for renal cysts masses. BJU IJU, 2005, vol. 95, pp. 939–942. DOI: 10.1111/j.1464-410X.2005.05442.x
  11. Bosniak, M.A. The use of the Bosniak classification system for renal cysts and cystic tumors. J. Urol., 1997, vol. 157, pp. 1852–1853.
  12. Maturen, K.E., Nghiem, H.V., Caoili, E.M., Higgins, E.G., Wolf jr., J.S., Wood jr., D.P. Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J. Roentgenol., 2007, vol. 188, pp. 563–570. DOI: 10.2214/AJR.06.0220
  13. Siroid, D.V., Antipov, N.V. Problemy operativnogo lecheniya varikotsele [Problems of surgical treatment of varicocele]. Klinicheskaya anatomiya i operativnaya khirurgiya [Clinical Anatomy and Surgical Surgery], 2009, vol. 8, no 4, pp. 76–78. (In Russian)
  14. Shamsa, A., Mohammadi, L., Abolbashari, M., Shakeri, M.T., Shamsa, S. Comparison of open and laparoscopic varicocelectomies in terms of operative time, sperm parameters, and complications. J. Urol., 2009, vol. 6, iss. 3, p. 170–175.
  15. Pan, L.J., Pan, F., Zhang, X.Y. Liu, Y., Zhang, F.L. Treatment of varicocele by microsurgical varicocelectomy: report of 94 cases. Zhonghua Nan Ke Xue, 2012, vol. 18, iss. 5, pp. 416–418. (In Chinese)
  16. Koryakin, M.V., Akopyan, A.S. Analiz prichin muzhskogo besplodiya [Analysis of the causes of male infertility]. Problemy reproduktsii [Problems of reproduction], 2000, no. 5, pp. 68–74. (In Russian)
  17. Haans, L.C., Laven, J.S., Mali, W.P. te Velde, E.R., Wensing, C.J. Testis volumes, semen quality, and hormonal patterns in adolescents with and without a varicocele. Fertil. Steril., 1991, vol. 56, pp. 731–736. DOI: 10.1016/S0015-0282(16)54607-X
  18. Volpe, A., Mattar, K., Finelli, A., Kachura, J.R., Evans, A.J., Geddie, W.R., Jewett, M.A. Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J. Urol., 2008, vol. 180, pp. 2333–2340. DOI: 10.1016/j.juro.2008.08.014
  19. Kolon, T.F., Clement, M.R., Cartwright, L., Bellah, R., Carr, M.C., Canning, D.A., Snyder III, H.M. Transient asynchronous testicular growth in adolescent males with a varicocele. J. Urol., 2008, vol. 180, pp. 1111–1114. DOI: 10.1016/j.juro.2008.05.061
  20. Chudnovets, L.G., Plechev, V.V., Garipov, R.M., Ishmetov, V.Sh. Ileospermaticheskiy tip varikotsele i ego vliyanie na fertil'nost' patsientov [Ileospermic type of varicocele and its effect on the fertility of patients]. Patologiya krovoobrashcheniya i kardiokhirurgiya [Pathology of blood circulation and cardiac surgery], 2008, no. 2, pp. 48–50. (In Russian)
  21. Kravtsov, Yu.A., Makarov, V.I., Sichinava, Z.A., Poushin, O.G., Dubolazova, I.Yu., Yavorskaya, M.V. Rol' venoznoy sistemy yaichek v regulyatsii urovnya polovykh gormonov v norme i patologii [The role of the venous system of the testes in regulating the level of sex hormones in normal and pathological conditions]. Flebologiya [Phlebology], 2012, no. 1, pp. 28–31. (In Russian)
  22. Tonyan, A.G., Medvedev, V.L, Tatevosyan, A.S., Tonyan, S.A., Butaeva, S.G. Zavisimost' sistolicheskogo arterial'nogo davleniya ot pozitsionnykh izmeneniy magistral'nogo venoznogo krovotoka pochki [Dependence of systolic blood pressure on positional changes in the main venous blood flow of the kidney]. Arterial'naya gipertenziya [Arterial hypertension], 2015, vol. 21, no. 5, pp. 477–486. (In Russian)
  23. Regirer, S.A. (ed.) Gidrodinamika krovoobrashcheniya. Mir, Moscow, 1971. (In Russian)
  24. Alekseenko, S.N., Medvedev, V.L., Tatevosyan, A.S., Tonyan, A.G., Pomortsev, A.V., Zhdamarova, O.I., Medvedev, A.V. Pozitsionnye izmeneniya magistral'nogo krovotoka levoy pochki u muzhchin s varikotsele i besplodiem [Positional changes in the main blood flow of the left kidney in men with varicocele and infertility]. Urologiya [Urology], 2014, no. 1, pp. 28–32. (In Russian)

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Issue

2020. Vol. 17. No. 1. Part 2

Section

Physics

Pages

81-91

Submitted

2020-01-24

Published

2020-03-31

How to Cite

Tonyan A.G., Tatevosyan A.S., Bunyakin A.V. Mathematical Modelling of Aorto-Mesenteric "Tweezers", Affecting the Relationship Between Dehydroepiandrostenedione and Testosterone in Persons with Varicocele. Ecological Bulletin of Research Centers of the Black Sea Economic Cooperation, 2020, vol. 17, no. 1, pp. 81-91. DOI: https://doi.org/10.31429/vestnik-17-1-2-81-91 (In Russian)

Copyright (c) 2020 Tonyan A.G., Tatevosyan A.S., Bunyakin A.V.

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