VARICOCELE: STATE-OF-THE-ART

According to the data available in the literature, the rate of varicocele in the general population is 10-30%. The prevalence of the disease increases with age and may be as great as 75-77,3%. With the introduction of current studies, almost 80% of cases of varicocele are found to have it bilaterally. Bilateral varicocele leads to hypotrophy of the testes and their considerably reduced volume regardless of the degree of the disease. Varicocele is a cause of primary and secondary male infertility in 40 and 80% of cases, respectively. The bilateral process can cause severe oligoasthenoteratozoospermia, including azoospermia. Sperm DNA fragmentation is more marked in men with varicocele. If untreated, varicocele may give rise to infertility even in those who have normal values of a spermogram. Microsurgical subvaginal varicocelectomy described by Marmara is the gold standard for treating patients with varicocele. Many works have provided support for the positive impact of varicocelectomy on the likelihood of spontaneous conception in the partners of patients, by improving their spermogram, reducing sperm DNA damage, normalizing blood hormone levels, elaborating fewer reactive oxygen species, and recovering Leydig cell function irrespective of patient age.

varicocele, infertility, hypogonadism, erectile dysfunction, varicocelectomy