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 .
Controlled trial of high spermatic vein ligation for varicocele in infertile men.
OBJECTIVE To determine whether high ligation is an effective treatment for infertile men with clinical varicocele . DESIGN A r and omized , controlled trial of high spermatic vein ligation was carried out . The patients were treated and observed for 3 years . SETTING Infertility treatment clinic and and rology laboratory in a hospital . PATIENTS Infertile men with abnormal semen analysis because of varicocele only . INTERVENTION High ligation 1 year postrecruitment ( group A ) and at the beginning of the study ( group B ) . RESULTS Among the 20 couples in group A , 2 pregnancies ( 10 % ) were achieved within the 1st year of observation period . During the year after high ligation , there were 8 pregnancies ( 44.4 % ) , and during the 2nd year after high ligation , there were 4 more pregnancies ( 22.2 % ) . In group B , 15 pregnancies ( 60 % ) occurred within the 1st year after operation . Three pregnancies ( 12 % ) and 1 pregnancy ( 4 % ) occurred during the 2nd and 3rd year , respectively . After operation in all patients of both groups , there was significant improvement in semen parameters , regardless of pregnancy occurrence . The difference in pregnancy rate ( PR ) between the operated group B and nonoperated group A during the 1st year of study was found to be highly significant . CONCLUSIONS It is concluded that in a population of infertile men presenting varicocele as the only demonstrable factor of infertility , the varicocele is clearly associated with infertility and reduced testicular function , and its correction by ligation improves sperm parameters and fertility rate . Furthermore , the highest PR in both groups occurred during the 1st year postoperation
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 .