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Revista Médica Sinergia

2022, Number 05

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Revista Médica Sinergia 2022; 7 (05)

Varicocele and male infertility

Moya RA, García VML, Cisneros OJ

Language: Spanish
References: 19
Page:
PDF size: 216.84 Kb.


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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