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Surgical Treatment of Varicocele

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Abstract

Varicocele has a high prevalence in males, being diagnosed in 35 % of men who present with primary infertility. Surgical correction of varicocele is a therapeutic option to solve infertility in some couples seeking offspring. Indications for surgical correction of varicocele depend on whether patients are adults or adolescents. In adults, surgical treatment is indicated in patients with scrotal pain, palpable varicocele, abnormal semen analysis, or wanting to have offspring. In adolescents, surgical treatment should be considered in patients with decreased testicular size and significant alterations in semen parameters.

Surgical treatment of varicocele consists of ligation and section of the spermatic veins at different anatomical levels (high retroperitoneal, inguinal, or subinguinal); such ligations may be performed by open or laparoscopic surgery. Another method of correcting the varicocele is through a percutaneous (femoral, jugular, or scrotal) embolization or injection of sclerosing substances into spermatic veins.

Varicocelectomy results with different surgical techniques are satisfactory achieving the disappearance of scrotal pain, if presented, and a pregnancy rate around 38 % of patients with fertility problems. Varicocelectomy results vary with surgical techniques depending on the different authors, but some studies show that surgical techniques of subinguinal microsurgery get the best results. Side effects with varicocelectomies are infrequent and of little clinical relevance.

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Authors and Affiliations

  1. Universidad Autónoma de Madrid (UAM), Department of Anatomy, Histology and Neuroscience, School of Medicine, Madrid, Spain

    Manuel Nistal

  2. School of Medicine, Universidad Autónoma de Madrid (UAM), University Hospital La Paz, Department of Pathology, Madrid, Spain

    Pilar González-Peramato

  3. University Hospital Clinico San Carlos, Department of Urology, Madrid, Spain

    Álvaro Serrano

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  1. Manuel Nistal
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  2. Pilar González-Peramato
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  3. Álvaro Serrano
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Correspondence to Manuel Nistal .

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Nistal, M., González-Peramato, P., Serrano, Á. (2017). Surgical Treatment of Varicocele. In: Clues in the Diagnosis of Non-tumoral Testicular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-49364-0_23

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  • DOI: https://doi.org/10.1007/978-3-319-49364-0_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49363-3

  • Online ISBN: 978-3-319-49364-0

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