• John P. Mulhall
  • Peter J. Stahl
  • Doron S. Stember


Varicocele refers to dilatation of the internal spermatic veins within the spermatic cord. Palpable varicoceles are found in approximately 15 % of the general male population and are the most commonly identified abnormality in infertile men, occurring in 35–40 % of cases. Although many men with varicoceles have ­normal fertility, significant evidence suggests that varicoceles negatively affect semen quality and fertility, and that varicocele repair improves semen quality and natural pregnancy rates. Aside from infertility, varicocele may cause scrotal pain and has been associated with testosterone deficiency. Rarely, varicocele may also be a presenting sign of occult retroperitoneal diseases including malignancy. The goal of the diagnostic evaluation is to determine whether or not the varicocele is clinically significant and to identify signs or symptoms that may be associated with the varicocele (infertility, pain, testicular atrophy, and/or testosterone deficiency). Treatment should be considered for patients with clinically significant varicoceles associated with signs or symptoms.


Spermatic Cord Semen Quality Spermatic Vein Testosterone Deficiency Scrotal Pain 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • John P. Mulhall
    • 1
  • Peter J. Stahl
    • 2
  • Doron S. Stember
    • 3
  1. 1.Sexual and Reprodictive Medicine Program Department of Surgery Division of Urology, Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of UrologyColumbia University College of Physicians & SurgeonsNew YorkUSA
  3. 3.Department of UrologyBeth Israel Medical Center Albert Einstein College of Medicine of Yeshiva UniversityNew YorkUSA

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