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 .
Treatment of varicocele: randomized prospective study on open surgery versus Tauber antegrade sclerotherapy.
The goal of this r and omized prospect i ve study in patients with varicocele was to evaluate the outcome following open surgery with inguinal approach versus ante grade sclerotherapy according to the Tauber procedure . From January 2002 to November 2003 , we recruited 64 patients with left varicocele for this study . All patients were clinical ly examined , before surgery and again 8 months postsurgery , by objective examination , scrotal color Doppler ultrasound , and semen analysis . These patients were r and omized in a balanced 4-block pattern : depending on r and omization , the patients underwent open surgery ( group A : 32 patients ) or ante grade sclerotherapy according to the Tauber procedure ( group B : 32 patients ) . At the current follow-up , it is possible to evaluate all the patients for whom we have preoperative and postoperative Doppler imaging and semen analysis . An analysis of seminal parameters shows a statistically significant improvement of the rate of fast progressive spermatozoa ( P < .05 ) and reduction in immotile spermatozoa ( P < .01 ) in those patients who underwent sclerotherapy compared to the patients who underwent open surgery . The outcomes of all other parameters ( number and morphology ) are fully comparable . Operating time is decidedly shorter for ante grade sclerotherapy ( P < .01 ) , but there are no significant differences in terms of early or late postoperative complications . It is widely known that varicocele is a condition found in 9 % to 23 % of the male population around the world ; this percentage rises to 40 % among infertile males . The treatment of this condition not only resolves clinical symptoms but also stops continuous damage to spermatogenesis , thereby potentially improving fertility . Our experience demonstrates that sclerotherapy ( Tauber procedure ) combines shorter surgical time and faster recovery of normal daily activities with significant improvement in sperm motility
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 .