{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:04:01Z","timestamp":1785135841291,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Fontan circulation may cause chronic venous hypertension and predispose patients to varicocele and infertility, but the clinical significance of surgical treatment remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We describe two patients with Fontan circulation who developed Fontan\u2010associated varicocele (FAVC). A 42\u2010year\u2010old man presented with secondary infertility, bilateral varicocele, and progression to azoospermia after Fontan surgery. A 28\u2010year\u2010old man had asthenozoospermia, bilateral varicocele, and repeated failure of assisted reproductive technology. Both underwent bilateral microsurgical varicocelectomy with perioperative heparin bridging. Postoperative semen parameters improved in both patients, with sperm reappearing in the first case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Varicocelectomy for FAVC may restore spermatogenesis in selected cases, but the risk of postoperative recurrence may be increased.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70206","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:46:24Z","timestamp":1781073984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Varicocelectomy Restores Spermatogenesis in Fontan\u2010Associated Varicocele: A Two\u2010Case Series"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3382-7990","authenticated-orcid":false,"given":"Yusuke","family":"Tominaga","sequence":"first","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Miyabi Urogyne Clinic  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Department of Urology Good Life Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0163-1906","authenticated-orcid":false,"given":"Takatoshi","family":"Moriwake","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nariaki","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Sadahira","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Bekku","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama 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