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Abstract
Varicocele is defined as a dilation of the testicular veins of the scrotal portion of the pampiniform plexus. It is one of the main causes of male infertility with surgical removal, ocurring in a significant percentage in those who are ruled out for some degree of primary or secondary infertility. There is strong evidence linking varicocele with male infertility, but the pathophysiological process by which it develops is not yet clarified, with noxa produced in the testicle being one of the main hypotheses since it generates testicular atrophy and inadequate spermatogenesis. Physycial examination is the “gold standard” in the diagnosis of varicocele, although the latest guidelines indicate that ultrasound should be performed in all patients under study. In the evaluation of fertility there are methods that provide valuable information, being the orchidometric measurements and the spermogram the most important ones. The management of varicocele has evolved in the last 30 years, however, it remains a controvesial issue, even though it has been shown that surgical procedures have high percentages of improvement in spermogram at 6 months postoperative. Currently, the guidelines recommend the surgical procedure in adults with persistent symptomatic varicocele that is resistant to conservative measures, regardless of the fertility status. In adolescents, the subject is even more complex, so parameters have been developed to make it easier for the clinician to decide whether or not to perform surgery, with testicular volumen and restrograde blood flow being the most relevant ones.
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References
Paivana V, Miranda C, de Oliveira-Gennaro F, Dos R. Genetics and epigenetics of varicocele pathophysiology: an overview. Journal of Assisted Reproduction and Genetics Internet. 2017 Jul cited 2022 Feb 26;34(7):839-847. Available from: https://pubmed.ncbi.nlm.nih.gov/28523408/
Kouroush A, Trustin D. Varicocele. Canadian Urological Association Journal Internet. 2018 Apr cited 2022 Feb 26;12(4 Suppl 1):S34-S36. Available from: https://pubmed.ncbi.nlm.nih.gov/29681272/
Zavattaro M, Ceruti C, Motta G, Allasia S, Marinelli L, Di Bisceglie C, Tagliabue M, Sibona M, Rolle L, Lanfranco F. Treating varicocele in 2018: current knowledge and treatment options. Journal of Endrocrinologial Investigation Internet. 2018 Dec cited 2022 Feb 26;41(12):1365-1375. Available from: https://pubmed.ncbi.nlm.nih.gov/30284221/
Cho C, Esteves S, Agarwal A. Indications and outcomes of varicocele repair. Panminerva Medica Internet. 2019 Jun cited 2022 Feb 26;61(2):152-163. Available from: https://pubmed.ncbi.nlm.nih.gov/30990285/
Paick S, Choi W. Varicocele and Testicular Pain: A Review. The World Journal of Men´s Health Internet. 2019 Jan cited 2022 Feb 26;37(1):4-11. Available from: https://pubmed.ncbi.nlm.nih.gov/29774668/
Min J, Don S. Current Issues in Adolescent Varicocele: Pediatric Urological Perspectives. The World Journal of Men´s Health Internet. 2018 May cited 2022 Feb 26;36(2):123-131. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5924953/
Paner M, Baskaran S, Agarwal A, Henkel R. Protein profiling in unlocking the basis of varicocele-associated infertility. Andrologia Internet. 2021 Feb cited 2022 Feb 26;53(1):e13465. Available from: https://pubmed.ncbi.nlm.nih.gov/32453911/
Sedaghatpour D, Berookhim B. The Role of Varicocele in Male Factor Subfertility. Current Urology Reports Internet. 2017 Sep cited 2022 Feb 26;18(9):73. Available from: https://pubmed.ncbi.nlm.nih.gov/28718159/
Su J, Farber N, Vij S. Pathophysiology and treatment options of varicocele: An overview. Andrologia Internet. 2021 Feb cited 2022 Feb 26;53(1):e13576. Available from: https://pubmed.ncbi.nlm.nih.gov/32271477/
Hassanin A., Ahmed H., Kaddah A. A global view of the pathophysiology of varicocele. Andrology Internet. 2018 Sep cited 2022 Feb 26;6(5):654-661. Available from: https://pubmed.ncbi.nlm.nih.gov/29978951/
Kohn J, Haney N, Nichols P, Rodríguez K, Kohn T. Varicocele Repair Prior to Assisted Reproductive Technology: Patient Selection and Special Considerations. Research and Reports in Urology Internet. 2020 Apr cited 2022 Feb 26;12:149-156. Available from: https://pubmed.ncbi.nlm.nih.gov/32426301/
Birowo P, Tendi W, Widyahening I, Atmoko W, Rasyid N. The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis. Heliyon Internet. 2020 Nov cited 2022 Feb 26;6(11):e05439. Available from: https://pubmed.ncbi.nlm.nih.gov/33204888/
Jensen C, Ostergren P, Dupree J, Ohl D, Sonksen J, Fode M. Varicocele and male infertility. Nature Reviews Urology Internet. 2017 Sep cited 2022 Feb 26;14(9):523-533. Available from: https://pubmed.ncbi.nlm.nih.gov/28675168/
Cannarella R, Calogero A, Condorelli R, Giacone F, Aversa A, La Vignera S. Management and Treatment of Varicocele in Children and Adolescents: An Endrocrinologic Perspective. Journal of Clinical Medicine Internet. 2019 Sep cited 2022 Feb 26;8(9):1410. Available from: https://pubmed.ncbi.nlm.nih.gov/31500355/
Macey M, Owen R, Ross S, Coward M. Best practice in the diagnosis and treatment of varicocele in children and adolescents. Therapeutic Advances in Urology Internet. 2018 Jun cited 2022 Feb 26;10(9):273-282. Available from: https://pubmed.ncbi.nlm.nih.gov/30116303/
Fang Y, Su Y, Xu Z, Zhao K, Liu C, Zhang H. Varicocele-Mediated Male Infertility: From the Perspective of Testicular Inmunity and Inflammation. Frontiers in Inmunology Internet. 2021 Aug cited 2022 Feb 27;12:729539. Available from: https://pubmed.ncbi.nlm.nih.gov/34531872/
Owen R, McCormick B, Figler B, Coward R. A review of varicocele repair for pain. Translational Andrology and Urology Internet. 2017 May cited 2022 Feb 27;6(Suppl 1):S20-S29. Available from: https://pubmed.ncbi.nlm.nih.gov/28725614/
Dave P, Farber N, Vij S. Conventional semen analysis and advanced sperm function tests in diagnosis and management of varicocele. Andrologia Internet. 2021 Mar cited 2022 Feb 27;53(2):e13629. Available from: https://pubmed.ncbi.nlm.nih.gov/32369238/
Johnson D, Sandlow J. Treatment of varicoceles: techniques and outcomes. Fertility and Sterility Internet. 2017 Sep cited 2022 Feb 27;108(3):378-384. Available from: https://pubmed.ncbi.nlm.nih.gov/28865535/
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