Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .
Update on treatment of varicocele: counselling as effective as occlusion of the vena spermatica.
This prospect i ve r and omized study was performed in order to investigate the effects of interventive treatment or counselling on pregnancy rates in infertile couples in whose male partners a varicocele was diagnosed . The present report extends a previous study using the same design . A total of 125 couples were included in the current study while the previous report comprised 95 couples . Couples fulfilling the inclusion criteria were allocated r and omly either to interventive treatment ( surgical ligation or angiographic embolization of the spermatic vein ) ( n = 62 ) or to counselling as the sole treatment ( n = 63 ) . Couples were followed over the subsequent 12 months and seen at 3-monthly intervals . At the end of the 12 month period pregnancy rates , as the main outcome measure , were 29 % in the group given interventive treatment and 25.4 % in the counselled group and were not significantly different . The only significant difference found , regardless of treatment modality , was the wives ' age at admittance  :  the 34 wives achieving a pregnancy were 28.8 + /- 0.6 years ( mean + /- SE ) old while the 91 non-pregnant wives were 31.2 + /- 0.3 years old ( P < 0.05 ) . The study suggests that regular counselling of the infertile couples is as effective as interventive treatment of varicoceles in achieving pregnancies
Taken together , the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy .
Abstract Despite being first described two thous and years ago , the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility , hypogonadism , and chronic orchidalgia .
The underlying mechanisms remain poorly understood and likely include hypoxia , oxidative stress , hyperthermia , anatomical aberrations , and genetics as primary components .
Despite a high prevalence amongst asymptomatic fertile men , varicoceles paradoxically also represent the most common correctable cause for male infertility .
In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations .
We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain .