Abstract
Varicoceles are cited as the most common cause of male infertility worldwide, yet not all men with varicocele experience difficulty with fecundity. There is an abundance of research and literature regarding varicoceles, but there remains significant controversy regarding their development and pathophysiology. The purpose of this chapter will be to provide an overview of the basic anatomy of varicoceles and discuss theories that explain their etiology.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Jarow JP, Coburn M, Sigman M. Incidence of varicoceles in men with primary and secondary infertility. Urology. 1996;47(1):73–6.
Sayfan J, Soffer Y, Orda R. Varicocele treatment: prospective randomized trial of 3 methods. J Urol. 1992;148(5):1447–9.
Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertil Steril. 1993;59(3):613–6.
World Health Organization. The influence ofvaricocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril. 1992;57:1289.
Noske HD, Weidner W. Varicocele--a historical perspective. World J Urol. 1999;17:151–7.
Tulloch WS. Varicocele in subfertility: results of treatment. Br Med J. 1955;2(4935):356–8.
Raman JD, Goldstein M. Intraoperative characterization of arterial vasculature in spermatic cord. Urology. 2004;64:561–4.
Kogan SJ. The pediatric varicocele. In: Gearhart JP, Rink RC, Mouriquand PDE, editors. Pediatric urology. New York: WB Saunders Co; 2001; chapt 48.
Beck EM, Schlegel PN, Goldstein M. Intraoperative varicocele anatomy: a macroscopic and microscopic study. J Urol. 1992;148:1190.
Wishahi MM. Anatomy of the spermatic venous plexus (pampiniform plexus) in men with and without varicocele: intraoperative venographic study. J Urol. 1992;147:1285–9.
Lechter A, Lopez G, Martinez C, Camacho J. Anatomy of the gonadal veins: a reappraisal. Surgery. 1991;109(6):735–9.
Favorito LA, Costa WS, Sampaio FJ. Applied anatomic study of testicular veins in adult cadavers and in human fetuses. Int Braz J Urol. 2007;33(2):176–80.
Valji K. Endocrine, exocrine and reproductive system. In: Valji K, editor. The practice of interventional radiology, with online cases and video. [Internet]. 1st ed. Philadelphia: Elsevier Saunders. p. 424.
Turner TT, Lopez TJ. Testicular blood flow in prepubertal and older rats with unilateral experimental varicocele and investigation into the mechanism of the bilateral response to the unilateral lesion. J Urol. 1982;144:1018.
Dahl EV, Herrick JF. A vascular mechanism for maintaining testicular temperatures by countercurrent exchange. Surg Gynecol Obstet. 1959;108:697–705.
Agger P. Scrotal and testicular temperature: its relation to sperm count before and after varicocelectomy. Fert Steril. 1971;22:286–97.
Bayard F, Boulard PY, Huc A, Pontonnier F. Arteriovenous transfer of testosterone in the spermatic cord of man. J Clin Endocrinol Metab. 1975;40:345–6.
Damsgaard J, Joensen UN, Carlsen E, Erenpreiss J, Blomberg Jensen M, Matulevicius V, et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 healthy young men from six European countries. Eur Urol. 2016;70:1019–29.
Shafik A, Bedeir GA. Venous tension patterns in cord veins. I. In normal and varicocele individuals. J Urol. 1980;123:383–5.
Coolsaet BL. The varicocele syndrome: venography determining the optimal level for surgical management. J Urol. 1980;124:833–9.
Gat Y, Zukerman Z, Chakraborty J, Gornish M. Varicocele, hypoxia and male infertility. Fluid mechanics analysis of the impaired testicular venous drainage system. Hum Reprod. 2005;20:2614–9.
Delaney DP, Carr MC, Kolon TF, Snyder HM, Zderic SA. The physical characteristics of young males with varicocele. BJU Int. 2004;94:624–6.
Nagler HM, Grotas AB. Varicocele. In: Lipshultz LI, Howards SS, Niederberger CS, editors. Infertility in the male. 4th ed. New York: Cambridge University Press; 2009. p. 331–61.
Shafik A, Moftah A, Olfat S, Mohi-el-din M, El-Sayed A. Testicular veins: anatomy and role in varicocelogenesis and other pathologic conditions. Urology. 1990;35:175.
Kass EJ. Adolescent varicocele. Pediatr Clin N Am. 2001;48:1559.
Sigmund G, Gall H, B€ahren W. Stop-type and shunttype varicoceles: venographic findings. Radiology. 1987;163:105–10.
Ahlberg NE, Bartley O, Chidekel N. Right and left gonadal veins: an anatomical and statistical study. Acta Radiol Diagn (Stockh). 1966;4:593–601.
Mohseni MJ, Nazari H, Amini E, Javan-Farazmand N, Baghayee A, Farzi H, et al. Shunt-type and stop-type varicocele in adolescents: prognostic value of these two different hemodynamic patterns. Fertil Steril. 2011;96(5):1091–6.
Yasim A, Resim S, Sahinkanat T, Eroglu E, Ari M, et al. Clinical and subclinical varicocele incidence in patients with primary varicose veins requiring surgery. Ann Vasc Surg. 2013;27:758–61.
Levinger U, Gornish M, Gat Y, Bachar GN. Is varicocele prevalence increasing with age? Andrologia. 2007;39:77–80.
Skoog SJ, Roberts KP, Goldstein M, Pryor JL. The adolescent varicocele: what’s new with an old problem in young patients? Pediatrics. 1997;100:112–22.
Gat Y, Gornish M, Chakraborty J, Perlow A, Levinger U, Pasqualotto F. Azoospermia and maturation arrest: malfunction of valves in erect poster of humans leads to hypoxia in sperm production site. Andrologia. 2010;42(6):389–94.
Shin JI, Lee JS, Kim MJ. The prevalence, physical characteristics and diagnosis of nutcracker syndrome. Eur J Vasc Endovasc Surg. 2006;32(3):335–6.
Shin JI, Park JM, Lee JS, Kim MJ. Effect of renal Doppler ultrasound on the detection of nutcracker syndrome in children with hematuria. Eur J Pediatr. 2007;166(5):399–404.
Okada M, Tsuzuki K, Ito S. Diagnosis of the nutcracker phenomenon using two-dimensional ultrasonography. Clin Nephrol. 1998;49(1):35–40.
Akbay E, Cayan S, Doruk E, Duce MN, Bozlu M. The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int. 2000;86(4):490–3.
Kim SH, Cho SW, Kim HD, Chung JW, Park JH, Han MC. Nutcracker syndrome: diagnosis with Doppler US. Radiology. 1996;198(1):93–7.
Takebayashi S, Ueki T, Ikeda N, Fujikawa A. Diagnosis of the nutcracker syndrome with color Doppler sonography: correlation with flow patterns on retrograde left renal venography. AJR Am J Roentgenol. 1999;172(1):39–43.
Zerin JR, Hernandez RJ, Sedman AB, Kelsch RC. Dilatation of the left renal vein on computed tomography in children: a normal variation. Pediatr Radiol. 1991;21:267–9.
Park SJ, Lim JW, Co BS, Yoon TY, Oh JH. Nutcracker syndrome in children with orthostatic proteinurea. J Ultrasound Med. 2002;21:39–45.
Unlu M, Orguc S, Serter S, Pekindil G, Pabuscu Y. Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome. Scand J Urol Nephrol. 2007;41:42–6.
Cho BS, Choi YM, Kang HH, Park SN, Lim JW, Yoon TY. Diagnosis of nut-cracker phenomenon using renal Doppler ultrasound in orthostatic proteinuria. Nephrol Dial Transplant. 2001;16:1620–5.
DeWitt ME, Green DJ, Gill B, Nyame Y, Haywood S, Sabanegh E. Isolated right varicocele and incidence of associated cancer. Urology. 2018;117:82–5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Parekh, N., Sabanegh, E. (2019). Anatomic Theories of Varicocele Origin. In: Esteves, S., Cho, CL., Majzoub, A., Agarwal, A. (eds) Varicocele and Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-319-79102-9_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-79102-9_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-79101-2
Online ISBN: 978-3-319-79102-9
eBook Packages: MedicineMedicine (R0)