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Asian Journal of Andrology 2016Varicocele is a common problem in reproductive medicine practice. A varicocele is identified in 15% of healthy men and up to 35% of men with primary infertility. The... (Review)
Review
Varicocele is a common problem in reproductive medicine practice. A varicocele is identified in 15% of healthy men and up to 35% of men with primary infertility. The exact pathophysiology of varicoceles is not very well understood, especially regarding its effect on male infertility. We have conducted a systematic review of studies evaluating the epidemiology of varicocele in the general population and in men presenting with infertility. In this article, we have identified some of the factors that can influence the epidemiological aspects of varicoceles. We also recognize that varicocele epidemiology remains incompletely understood, and there is a need for well-designed, large-scale studies to fully define the epidemiological aspects of this condition.
Topics: Humans; Infertility, Male; Male; Varicocele
PubMed: 26763551
DOI: 10.4103/1008-682X.172640 -
JAMA Jun 2020
Topics: Embolization, Therapeutic; Humans; Infertility, Male; Male; Varicocele
PubMed: 32484535
DOI: 10.1001/jama.2020.0397 -
BMJ Clinical Evidence Jul 2015Varicocele is estimated to affect about 15% of the general male population. It usually occurs only on the left side, and is often asymptomatic. There is little evidence... (Review)
Review
INTRODUCTION
Varicocele is estimated to affect about 15% of the general male population. It usually occurs only on the left side, and is often asymptomatic. There is little evidence that varicocele reduces male fertility, although it is found in 12% of male partners of couples presenting with infertility and in 25% of men with abnormal semen analysis.
METHODS AND OUTCOMES
We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments in adult males with varicocele? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
RESULTS
Searching of electronic databases retrieved 203 studies. After deduplication and removal of conference abstracts, 91 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 53 studies and the further review of 38 full publications. Of the 38 full articles evaluated, one existing systematic review was updated and two systematic reviews and five RCTs were added at this update. We performed a GRADE evaluation of nine PICO combinations.
CONCLUSIONS
In this systematic overview we categorised the efficacy for four interventions, based on information relating to the effectiveness of embolisation, expectant management, sclerotherapy, and surgical ligation.
Topics: Humans; Male; Sclerotherapy; Varicocele
PubMed: 26168774
DOI: No ID Found -
Ugeskrift For Laeger May 2020In this review, we discuss varicocele testis, which is found in 15% of men from the general population, but more frequently in infertile populations. It can cause... (Review)
Review
In this review, we discuss varicocele testis, which is found in 15% of men from the general population, but more frequently in infertile populations. It can cause physical symptoms or impaired fertility. Varicocele severity is graded 1-3 by clinical examination, and increasing grade is associated with poorer semen quality. Treatment effect on symptoms and fertility has been documented. A microsurgical approach seems to have the best outcome in terms of lowest frequency of recurrence and complication. Treatment of this common condition is recommended only in patients with symptoms or evidence of affected testicular function.
Topics: Fertility; Humans; Infertility; Male; Semen Analysis; Testis; Varicocele
PubMed: 32400385
DOI: No ID Found -
Asian Journal of Andrology 2015Testicular varicocele, a dilation of the veins of the pampiniform plexus thought to increase testicular temperature via venous congestion, is commonly associated with... (Review)
Review
Testicular varicocele, a dilation of the veins of the pampiniform plexus thought to increase testicular temperature via venous congestion, is commonly associated with male infertility. Significant study has clarified the negative impact of varicocele on semen parameters and more recent work has shed light on its detrimental effects on the molecular and ultrastructural features of sperm and the testicular microenvironment, as well as more clearly defined the positive impacts of treatment on couples' fertility. The relationship between varicocele and testicular endocrine function, while known for some time based on histologic evaluation, has become more apparent in the clinical setting with a growing link between varicocele and hypogonadism. Finally, in the pediatric setting, while future study will clarify the impact of varicocele on fertility and testicular function, recent work supports a parallel effect of varicocele in adolescents and adults, suggesting a re-evaluation of current treatment approaches in light of the progressive nature of the condition and potential increased risk of future disease.
Topics: Adolescent; Adult; Fertility; Humans; Infertility, Male; Male; Reproductive Techniques, Assisted; Spermatozoa; Testis; Varicocele
PubMed: 25926610
DOI: 10.4103/1008-682X.153539 -
Seminars in Cell & Developmental Biology Jan 2022Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a... (Review)
Review
Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a proportion of men with varicoceles can suffer from infertility and testosterone deficiency. Sperm and testosterone are produced within the testis, and any alteration to the testicular environment can negatively affect the cells responsible for these processes. The negative impact of varicoceles on testicular function occurs mainly due to increased oxidative stress within the testicular parenchyma which is thought to be caused by scrotal hyperthermia, testicular hypoxia, and blood-testis barrier disruption. Management of varicoceles involves ligation or percutaneous embolization of the dilated veins. Repair of varicoceles can improve semen parameters and fertility, along with serum testosterone concentration. In this review, we discuss the pathophysiology of varicoceles, their impact on testicular function, and management.
Topics: Humans; Infertility, Male; Male; Spermatogenesis; Testosterone; Varicocele
PubMed: 33965333
DOI: 10.1016/j.semcdb.2021.04.005 -
Human Fertility (Cambridge, England) Apr 2021
Topics: Humans; Male; Varicocele
PubMed: 33886415
DOI: 10.1080/14647273.2021.1916145 -
Endocrinology and Metabolism Clinics of... Dec 2015Varicoceles are associated with testicular atrophy and abnormal spermatogenesis. Varicocele-related testicular damage is thought to be progressive in nature. Adult... (Review)
Review
Varicoceles are associated with testicular atrophy and abnormal spermatogenesis. Varicocele-related testicular damage is thought to be progressive in nature. Adult varicoceles are common in men with infertility, and varicocele repair in this population has demonstrated improved semen parameters and paternity outcomes. However, without solid objective endpoints (reproducible semen analyses, paternity), the indications for adolescent varicocele repair remain controversial. Given the controversy surrounding adolescent varicocele management, it is not surprising that surveys of pediatric urologists have revealed a lack of consensus on diagnostic approaches, treatment decisions, and operative approaches.
Topics: Adolescent; Humans; Infertility, Male; Male; Varicocele
PubMed: 26568496
DOI: 10.1016/j.ecl.2015.07.007 -
Panminerva Medica Jun 2019Varicoceles exert deleterious effect on testicular function. The condition has been associated with male infertility, testicular hypotrophy and pain. These comprises the... (Review)
Review
Varicoceles exert deleterious effect on testicular function. The condition has been associated with male infertility, testicular hypotrophy and pain. These comprises the common indications for varicocele repair currently. Significant improvement in semen parameters and pregnancy outcomes had been suggested by reports decades ago. However, selection of the best candidates remains an issue since not all patients respond positively to treatment. Consensus has been reached in recent decade after the publication of a series of meta-analyses. Significant improvement in pregnancy outcomes were reported in patients with clinical varicocele and abnormal semen parameters. Varicocelectomy in adolescents with testicular hypotrophy was supported by the positive implication on catch-up growth and semen parameters. However, little is known about the treatment effect of adolescence varicocelectomy on long term fertility and paternity rate. Recent studies on outcome of varicocele repair for pain consistently demonstrated a resolution rate of approximately 90% and support varicocele-associated pain as an indication for surgery. Alternate indications for varicocele repair have been proposed in recent decade. Despite the encouraging preliminary data, most studies were uncontrolled retrospective series. Although varicocelectomy may not obviate the need for assisted reproductive techniques in patients with non-obstructive azoospermia, it potentially increases sperm retrieval rate. The significant increase in serum testosterone after varicocelectomy in patients with androgen deficiency may open an alternative treatment for hypogonadism. The adjunctive role of varicocelectomy before assisted reproduction and the significant decrease in sperm DNA fragmentation after varicocele repair deserve further well-designed controlled studies.
Topics: Adolescent; Androgens; Azoospermia; DNA Fragmentation; Humans; Infertility, Male; Male; Oxidative Stress; Reproductive Techniques, Assisted; Testis; Urogenital Surgical Procedures; Varicocele
PubMed: 30990285
DOI: 10.23736/S0031-0808.18.03528-0 -
Fertility and Sterility Sep 2017In this Views and Reviews section, four groups of authors address the timely and highly relevant issue of varicoceles across the male life spectrum. Varicoceles are very...
In this Views and Reviews section, four groups of authors address the timely and highly relevant issue of varicoceles across the male life spectrum. Varicoceles are very prevalent among men presenting for an infertility workup. While reduction in bulk semen parameters (including sperm concentration, motility, and morphology) has long been recognized as a deficit caused by varicoceles, in recent years a number of investigators have shown that varicoceles can have broader, multi-faceted effects on male reproductive health. Sperm DNA integrity and other aspects of sperm function appear to be impacted by the presence of varicoceles, and varicocele correction can result in significant improvement in not only semen parameters, but also fertilization and pregnancy rates.
Topics: Combined Modality Therapy; Embolization, Therapeutic; Evidence-Based Medicine; Humans; Infertility, Male; Male; Treatment Outcome; Urogenital Surgical Procedures; Varicocele; Vascular Surgical Procedures
PubMed: 28865533
DOI: 10.1016/j.fertnstert.2017.07.1161