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Semin intervent Radiol 2016; 33(03): 170-176
DOI: 10.1055/s-0036-1586147
DOI: 10.1055/s-0036-1586147
Review Article
Varicocele: A Review
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
30. August 2016 (online)
![](https://www.thieme-connect.de/media/sir/201603/lookinside/thumbnails/10-1055-s-0036-1586147_00961-1.jpg)
Abstract
Varicoceles are relatively common clinical problem that are associated with pain, testicular atrophy, and reduced fertility rates. After a brief historical perspective is presented, this article reviews the anatomy, indications, treatment options, and potential complications related to varicoceles.
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References
- 1 Nöske HD, Weidner W. Varicocele—a historical perspective. World J Urol 1999; 17 (3) 151-157
- 2 Kaufman SL, Nagler HM. The varicocele: concepts of pathophysiology - present and future. World J Urol 1986; 4 (2) 88-91
- 3 Halpern J, Mittal S, Pereira K, Bhatia S, Ramasamy R. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications. Asian J Androl 2016; 18 (2) 234-238
- 4 Rothman CM. The varicocele—1800. Urology 1980; 15 (1) 99-100
- 5 Ivanissevich C, Gregorini H. Una nueva operacion para curar el varicocele. Sem Med 1918; 25: 575
- 6 Palomo A. Radical cure of varicocele by a new technique; preliminary report. J Urol 1949; 61 (3) 604-607
- 7 Kaye KW. Modified high varicocelectomy: outpatient microsurgical procedure. Urology 1988; 32 (1) 13-16
- 8 Tulloch WS. Varicocele in subfertility; results of treatment. BMJ 1955; 2 (4935) 356-358
- 9 Hagood PG, Mehan DJ, Worischeck JH, Andrus CH, Parra RO. Laparoscopic varicocelectomy: preliminary report of a new technique. J Urol 1992; 147 (1) 73-76
- 10 Little AF, Lavoipierre AM. Unusual clinical manifestations of the Nutcracker Syndrome. Australas Radiol 2002; 46 (2) 197-200
- 11 Pallwein L, Pinggera G, Schuster AH , et al. The influence of left renal vein entrapment on outcome after surgical varicocele repair: a color Doppler sonographic demonstration. J Ultrasound Med 2004; 23 (5) 595-601
- 12 Masson P, Brannigan RE. The varicocele. Urol Clin North Am 2014; 41 (1) 129-144
- 13 Zini A, Boman JM. Varicocele. In: Goldstein M, Schlegel PN, , eds. Surgical and Medical Management of Male Infertility. Cambridge: Cambridge University Press; 2003: 137-149
- 14 Mehta AL, Dogra VS. Intratesticular varicocele. J Clin Ultrasound 1998; 26 (1) 49-51
- 15 Sofikitis N, Dritsas K, Miyagawa I, Koutselinis A. Anatomical characteristics of the left testicular venous system in man. Arch Androl 1993; 30 (2) 79-85
- 16 Grieme B, Akman A, Albayati A, Timmreck EJ, Tanski EM, Venbrux AC. Management of male varicocele. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, , eds. Image-Guided Interventions. 2nd ed. Philadelphia, PA: Saunders; 2014: 559-562
- 17 Asala S, Chaudhary SC, Masumbuko-Kahamba N, Bidmos M. Anatomical variations in the human testicular blood vessels. Ann Anat 2001; 183 (6) 545-549
- 18 Biswass S, Chattopadhyay JC, Panicker H, Anbalagan J, Ghosh SK. Variations in renal and testicular veins—a case report. J Anat Soc India 2006; 55 (2) 69-71
- 19 Rosalino UAC, Latorre GC, Pinto AC, Toscano MP. Uncommon drainage of the gonadal vein: case report. Braz J Morphol Sci 2011; 28 (2) 135-136
- 20 Fretz PC, Sandlow JI. Varicocele: current concepts in pathophysiology, diagnosis, and treatment. Urol Clin North Am 2002; 29 (4) 921-937
- 21 Clarke BG. Incidence of varicocele in normal men and among men of different ages. JAMA 1966; 198 (10) 1121-1122
- 22 Practice Committee of American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2008; 90 (5, Suppl): S247-S249
- 23 Levinger U, Gornish M, Gat Y, Bachar GN. Is varicocele prevalence increasing with age?. Andrologia 2007; 39 (3) 77-80
- 24 Canales BK, Zapzalka DM, Ercole CJ , et al. Prevalence and effect of varicoceles in an elderly population. Urology 2005; 66 (3) 627-631
- 25 Diamond DA. Adolescent varicocele: emerging understanding. BJU Int 2003; 92 (Suppl. 01) 48-51
- 26 Raman JD, Walmsley K, Goldstein M. Inheritance of varicoceles. Urology 2005; 65 (6) 1186-1189
- 27 Geatti O, Gasparini D, Shapiro B. A comparison of scintigraphy, thermography, ultrasound and phlebography in grading of clinical varicocele. J Nucl Med 1991; 32 (11) 2092-2097
- 28 Ficarra V, Cerruto MA, Liguori G , et al. Treatment of varicocele in subfertile men: The Cochrane Review—a contrary opinion. Eur Urol 2006; 49 (2) 258-263
- 29 Iaccarino V, Venetucci P. Interventional radiology of male varicocele: current status. Cardiovasc Intervent Radiol 2012; 35 (6) 1263-1280
- 30 Jarow JP. Effects of varicocele on male fertility. Hum Reprod Update 2001; 7 (1) 59-64
- 31 McClure RD, Khoo D, Jarvi K, Hricak H. Subclinical varicocele: the effectiveness of varicocelectomy. J Urol 1991; 145 (4) 789-791
- 32 Evers JLH, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 2003; 361 (9372) 1849-1852
- 33 Comhaire FH, Kunnen M. Factors affecting the probability of conception after treatment of subfertile men with varicocele by transcatheter embolization with Bucrylate. Fertil Steril 1985; 43 (5) 781-786
- 34 Dhabuwala CB, Hamid S, Moghissi KS. Clinical versus subclinical varicocele: improvement in fertility after varicocelectomy. Fertil Steril 1992; 57 (4) 854-857
- 35 Cantoro U, Polito M, Muzzonigro G. Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology 2015; 85 (4) 826-830
- 36 Seo JT, Kim KT, Moon MH, Kim WT. The significance of microsurgical varicocelectomy in the treatment of subclinical varicocele. Fertil Steril 2010; 93 (6) 1907-1910
- 37 Sofikitis N, Miyagawa I. Effects of surgical repair of experimental left varicocele on testicular temperature, spermatogenesis, sperm maturation, endocrine function, and fertility in rabbits. Arch Androl 1992; 29 (2) 163-175
- 38 Zorgniotti AW, Macleod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril 1973; 24 (11) 854-863
- 39 Goldstein M, Eid JF. Elevation of intratesticular and scrotal skin surface temperature in men with varicocele. J Urol 1989; 142 (3) 743-745
- 40 Comhaire F, Vermeulen A. Varicocele sterility: cortisol and catecholamines. Fertil Steril 1974; 25 (1) 88-95
- 41 Ito H, Fuse H, Minagawa H, Kawamura K, Murakami M, Shimazaki J. Internal spermatic vein prostaglandins in varicocele patients. Fertil Steril 1982; 37 (2) 218-222
- 42 Hendin BN, Kolettis PN, Sharma RK, Thomas Jr AJ, Agarwal A. Varicocele is associated with elevated spermatozoal reactive oxygen species production and diminished seminal plasma antioxidant capacity. J Urol 1999; 161 (6) 1831-1834
- 43 Kilinç F, Kayaselcuk F, Aygun C, Guvel S, Egilmez T, Ozkardes H. Experimental varicocele induces hypoxia inducible factor-1alpha, vascular endothelial growth factor expression and angiogenesis in the rat testis. J Urol 2004; 172 (3) 1188-1191
- 44 Lipshultz LI, Corriere Jr JN. Progressive testicular atrophy in the varicocele patient. J Urol 1977; 117 (2) 175-176
- 45 Scott LS. Varicocele: a treatable cause of subfertility. BMJ 1961; 1 (5228) 788-790
- 46 Saleh R, Mahfouz RZ, Agarwal A, Farouk H. Histopathologic patterns of testicular biopsies in infertile azoospermic men with varicocele. Fertil Steril 2010; 94 (6) 2482-2485 , 2485.e1–2485.e2
- 47 Chawla A, Kulkarni G, Kamal K, Zini A. Microsurgical varicocelectomy for recurrent or persistent varicoceles associated with orchalgia. Urology 2005; 66 (5) 1072-1074
- 48 Puche-Sanz I, Flores-Martín JF, Vázquez-Alonso F, Pardo-Moreno PL, Cózar-Olmo JM. Primary treatment of painful varicocoele through percutaneous retrograde embolization with fibred coils. Andrology 2014; 2 (5) 716-720
- 49 Peterson AC, Lance RS, Ruiz HE. Outcomes of varicocele ligation done for pain. J Urol 1998; 159 (5) 1565-1567
- 50 Kass EJ, Marcol B. Results of varicocele surgery in adolescents: a comparison of techniques. J Urol 1992; 148 (2 Pt 2) 694-696
- 51 Muthuveloe DW, During V, Ashdown D, Rukin NJ, Jones RG, Patel P. The effectiveness of varicocele embolisation for the treatment of varicocele related orchalgia. Springerplus 2015; 4: 392
- 52 Dubin L, Amelar RD. The varicocele and infertility. In: Dubin L, Amelar RD, , eds. Male infertility. Philadelphia, PA: Saunders; 1977: 57-68
- 53 Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology 2003; 227 (1) 18-36
- 54 Sakamoto H, Saito K, Shichizyo T, Ishikawa K, Igarashi A, Yoshida H. Color Doppler ultrasonography as a routine clinical examination in male infertility. Int J Urol 2006; 13 (8) 1073-1078
- 55 Liguori G, Trombetta C, Garaffa G , et al. Color Doppler ultrasound investigation of varicocele. World J Urol 2004; 22 (5) 378-381
- 56 Ghanem H, Anis T, El-Nashar A, Shamloul R. Subinguinal microvaricocelectomy versus retroperitoneal varicocelectomy: comparative study of complications and surgical outcome. Urology 2004; 64 (5) 1005-1009
- 57 Diegidio P, Jhaveri JK, Ghannam S, Pinkhasov R, Shabsigh R, Fisch H. Review of current varicocelectomy techniques and their outcomes. BJU Int 2011; 108 (7) 1157-1172
- 58 Reyes BL, Trerotola SO, Venbrux AC , et al. Percutaneous embolotherapy of adolescent varicocele: results and long-term follow-up. J Vasc Interv Radiol 1994; 5 (1) 131-134
- 59 Prasivoravong J, Marcelli F, Lemaître L , et al. Beneficial effects of varicocele embolization on semen parameters. Basic Clin Androl 2014; 24 (9) 9
- 60 Urbano J, Cabrera M, Alonso-Burgos A. Sclerosis and varicocele embolization with N-butyl cyanoacrylate: experience in 41 patients. Acta Radiol 2014; 55 (2) 179-185
- 61 Hawkins CM, Racadio JM, McKinney DN, Racadio JM, Vu DN. Varicocele retrograde embolization with boiling contrast medium and gelatin sponges in adolescent subjects: a clinically effective therapeutic alternative. J Vasc Interv Radiol 2012; 23 (2) 206-210
- 62 Storm DW, Hogan MJ, Jayanthi VR. Initial experience with percutaneous selective embolization: a truly minimally invasive treatment of the adolescent varicocele with no risk of hydrocele development. J Pediatr Urol 2010; 6 (6) 567-571
- 63 Gandini R, Konda D, Reale CA , et al. Male varicocele: transcatheter foam sclerotherapy with sodium tetradecyl sulfate—outcome in 244 patients. Radiology 2008; 246 (2) 612-618
- 64 Sze DY, Kao JS, Frisoli JK, McCallum SW, Kennedy II WA, Razavi MK. Persistent and recurrent postsurgical varicoceles: venographic anatomy and treatment with N-butyl cyanoacrylate embolization. J Vasc Interv Radiol 2008; 19 (4) 539-545
- 65 Di Bisceglie C, Fornengo R, Grosso M , et al. Follow-up of varicocele treated with percutaneous retrograde sclerotherapy: technical, clinical and seminal aspects. J Endocrinol Invest 2003; 26 (11) 1059-1064
- 66 Vanlangenhove P, Everaert K, Van Maele G, Defreyne L. Tolerance of glue embolization under local anesthesia in varicoceles: a comparative study of two different cyanoacrylates. Eur J Radiol 2014; 83 (3) 559-563
- 67 Seyferth W, Jecht E, Zeitler E. Percutaneous sclerotherapy of varicocele. Radiology 1981; 139 (2) 335-340
- 68 Sigmund G, Bähren W, Gall H, Lenz M, Thon W. Idiopathic varicoceles: feasibility of percutaneous sclerotherapy. Radiology 1987; 164 (1) 161-168
- 69 Lenz M, Hof N, Kersting-Sommerhoff B, Bautz W. Anatomic variants of the spermatic vein: importance for percutaneous sclerotherapy of idiopathic varicocele. Radiology 1996; 198 (2) 425-431
- 70 Shlansky-Goldberg RD, VanArsdalen KN, Rutter CM , et al. Percutaneous varicocele embolization versus surgical ligation for the treatment of infertility: changes in seminal parameters and pregnancy outcomes. J Vasc Interv Radiol 1997; 8 (5) 759-767
- 71 Kim J, Shin JH, Yoon HK , et al. Persistent or recurrent varicocoele after failed varicocoelectomy: outcome in patients treated using percutaneous transcatheter embolization. Clin Radiol 2012; 67 (4) 359-365
- 72 Beddy P, Geoghegan T, Browne RF, Torreggiani WC. Testicular varicoceles. Clin Radiol 2005; 60 (12) 1248-1255
- 73 Kroese ACJ, de Lange NM, Collins J, Evers JLH. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev 2012; 10 (10) CD000479
- 74 Gazzera C, Rampado O, Savio L, Di Bisceglie C, Manieri C, Gandini G. Radiological treatment of male varicocele: technical, clinical, seminal and dosimetric aspects. Radiol Med (Torino) 2006; 111 (3) 449-458
- 75 Sivanathan C, Abernethy LJ. Retrograde embolisation of varicocele in the paediatric age group: a review of 10 years' practice. Ann R Coll Surg Engl 2003; 85 (1) 50-51
- 76 Chomyn JJ, Craven WM, Groves BM, Durham JD. Percutaneous removal of a Gianturco coil from the pulmonary artery with use of flexible intravascular forceps. J Vasc Interv Radiol 1991; 2 (1) 105-106
- 77 Vicini P, Di Pierro GB, Grande P , et al. Large bowel infarct following antegrade scrotal sclerotherapy for varicocele: a case report. Can Urol Assoc J 2014; 8 (9–10) E641-E643