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 .
Effect of microsurgical subinguinal varicocele ligation to treat pain.
OBJECTIVES The traditional treatment for a painful varicocele consists of conservative measures followed by varicocelectomy . We report our results with microsurgical subinguinal varicocele ligation to treat pain . METHODS From 1996 to 1999 , a total of 119 men underwent subinguinal microsurgical varicocele ligation for painful varicocele . The diagnosis of varicocele was based on the findings of both physical examination and color Doppler ultrasound . Patients described pain with testicular discomfort as scrotal heaviness or a dull ache . While waiting for the operation ( range 3 to 5 weeks ) , all the patients underwent a preoperative trial of conservative management for pain . RESULTS Of 119 men , 82 ( 69 % ) were available for follow-up 3 months postoperatively . Of those 82 patients , 72 ( 88 % ) reported complete resolution of pain , 4 patients ( 5 % ) partial resolution , 5 patients ( 6 % ) no change , and 1 patient ( 1 % ) epididymal discomfort that resolved with conservative measures . Of the 9 patients with partial or no change , 2 patients had reflux recurrence as seen on color Doppler ultrasound . CONCLUSIONS Subinguinal microsurgical varicocele ligation is an effective treatment for painful varicocele when performed in selected patients
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 .