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Varicocele

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Andrology

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Abstract

Varicocele is the enlargement, elongation, and varicose tortuosity of the pampiniform plexus in the scrotum. Approximately, 25–35% of infertile men have a clinical varicocele, but a similar prevalence is also found in fertile men. Varicocele can lead to decreased blood flow and volume depletion of the testis, as well as to elevation of scrotal temperature, oxidative stress, and increased DNA fragmentation, which are discussed as causes of infertility. Diagnosis must include a thorough physical and sonographic examination with Valsalva maneuver. Familial clustering of varicocele suggests genetic or epigenetic causes. Surgical and angiographic procedures aimed at occlusion of the spermatic vein are treatment modalities. Recent guidelines are cautious about interventional therapy. Treatment of subclinical varicocele is discouraged. If at all, treatment is most likely to be considered in men with clinical varicocele and abnormal ejaculate levels in the setting of otherwise unexplained couple infertility and adequate ovarian reserve in the female. Long-term fertility and paternity studies are lacking to assess the success of varicocele treatment in adolescents.

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Authors and Affiliations

  1. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Eberhard Nieschlag & Sabine Kliesch

  2. Center for Reproductive Medicine and Andrology, University Hospital Halle (Saale), Halle (Saale), Germany

    Hermann M. Behre

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  1. Eberhard Nieschlag
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  2. Sabine Kliesch
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Correspondence to Eberhard Nieschlag .

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Editors and Affiliations

  1. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Eberhard Nieschlag

  2. Center for Reproductive Medicine and Andrology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany

    Hermann M. Behre

  3. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Sabine Kliesch

  4. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Susan Nieschlag

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Nieschlag, E., Kliesch, S., Behre, H.M. (2023). Varicocele. In: Nieschlag, E., Behre, H.M., Kliesch, S., Nieschlag, S. (eds) Andrology. Springer, Cham. https://doi.org/10.1007/978-3-031-31574-9_18

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  • DOI: https://doi.org/10.1007/978-3-031-31574-9_18

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