{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T20:28:43Z","timestamp":1779308923444,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy of keishibukuryogan, a traditional Kampo formula known to be an anti\u2010<jats:italic>Oketsu<\/jats:italic> (impaired microcirculation and non\u2010physiological blood congestion) drug, in combination with an anti\u2010oxidant for the treatment of varicoceles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 119 patients with palpable and subclinical varicoceles who were treated with 7.5\u2009g\/day of keishibukuryogan and 600\u2009mg\/day of tocopherol nicotinate. Their motile sperm concentrations at the start of medication and after 3\u2009months were compared. As a subgroup analysis, a comparison test was carried out between patients with a high\u2010grade varicocele and those with a low\u2010grade varicocele.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the study patients was 35.6\u2009years. Among them, 17, 41, 44 and 17 had subclinical, grade\u20091, grade\u20092 and grade\u20093 varicoceles, respectively. Overall, the differences in motile sperm concentration (millions\/mL) before and after treatment were not significant (median 0.58, 95% confidence interval \u22120.12 to 1.56; <jats:italic>P<\/jats:italic>\u2009=\u20090.115). The results of the subgroup analysis showed that the motile sperm concentration in patients with a low\u2010grade varicocele significantly increased (median 1.21, 95% confidence interval 0.45\u20132.47; <jats:italic>P<\/jats:italic>\u2009=\u20090.024); however, no significant improvements were seen in patients with a high\u2010grade varicocele.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of the present study showed that the combination of keishibukuryogan and an anti\u2010oxidant had a limited effect on varicoceles, but they suggest that it is effective for the treatment of low\u2010grade varicoceles.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14746","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T08:34:02Z","timestamp":1637915642000},"page":"165-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of keishibukuryogan combined with tocopherol nicotinate on sperm parameters in patients with a varicocele"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-5487","authenticated-orcid":false,"given":"Teppei","family":"Takeshima","sequence":"first","affiliation":[{"name":"Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurii","family":"Karibe","sequence":"additional","affiliation":[{"name":"Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa 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Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Komeya","sequence":"additional","affiliation":[{"name":"Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0909-478X","authenticated-orcid":false,"given":"Yasushi","family":"Yumura","sequence":"additional","affiliation":[{"name":"Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Kanagawa 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