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.
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Abdel-Meguid TA, Al-Sayyad A, Tayib A, Farsi HM. Does varicocele repair improve male infertility? an evidence-based perspective from a randomized, controlled trial. Eur Urol. 2011;59(3):455–61.PubMedCrossRefGoogle Scholar
Cozzolino DJ, Lipshultz LI. Varicocele as a progressive lesion: positive effect of varicocele repair. Hum Reprod Update. 2001;7(1):55–8.PubMedCrossRefGoogle Scholar
Esteves SC, Oliveira FV, Bertolla RP. Clinical outcome of intracytoplasmic sperm injection in infertile men with treated and untreated clinical varicocele. J Urol. 2010;184(4):1442–6.PubMedCrossRefGoogle Scholar
Fretz PC, Sandlow JI. Varicocele: current concepts in pathophysiology, diagnosis, and treatment. Urol Clin North Am. 2002;29(4):921–37.PubMedCrossRefGoogle Scholar
Lee R, Li PS, Goldstein M, Schattman G, Schlegel PN. A decision analysis of treatments for nonobstructive azoospermia associated with varicocele. Fertil Steril. 2009;92(1):188–96.PubMedCrossRefGoogle Scholar
Male Infertility Best Practice Policy Committee of the American Urological Association, Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril. 2004;82 Suppl 1:S142–5.Google Scholar
Park HJ, Lee SS, Park NC. Predictors of pain resolution after varicocelectomy for painful varicocele. Asian J Androl. 2011;13(5):754–8.PubMedCrossRefGoogle Scholar
Stahl P, Schlegel PN. Standardization and documentation of varicocele evaluation. Curr Opin Urol. 2011;21(6):500–5.PubMedCrossRefGoogle Scholar