Pathophysiological effect of varicocele treatment


Varicocele is caused by inversion of blood flow through the internal spermatic vein(s), being bilateral in between one quarter to one third of cases. Treatment results in improvement of sperm characteristics in 70 to 80 % of patients. Pregnancy occurs in about one third of couples within one year after treatment, and in between 60 and 75 % of couples within two years [3]. Not all cases will benefit from treatment. Men combining varicocele and azoospermia with highly elevated FSH probably present irreversible damage to spermatogenesis. Cases with azoospermia but normal testicular volume and FSH may present obstruction of sperm transport which, obviously, will not be cured by varicocele treatment. Also, men with varicocele but normal semen analysis should not be treated, since couple infertility is not caused by the varicocele but rather results from a female factor. Since testicular volume decreases with increasing clinical grade of the varicocele [11], men combining low grade (grade I) or subclinical varicoceles and small testicular volume may suffer from complementary pathology, and they have little chance of having their fertility restored after varicocele treatment. The question remains why the majority of men with varicocele and (moderate) sperm deficiency do respond favourably to treatment, but some others do not. In order to answer this question, one should try to understand the pathophysiological mechanisms of varicocele treatment. Effect of interruption of spermatic venous reflux on testicular perfusion

DOI: 10.1007/s001200050179

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@article{Comhaire1998PathophysiologicalEO, title={Pathophysiological effect of varicocele treatment}, author={Frank H. Comhaire and Adel Abd El-Kader Zalata and A. Mahmoud and Charlotte Depuydt}, journal={Der Urologe A}, year={1998}, volume={37}, pages={251-253} }