Varicocele as a source of male infertility - current treatment techniques

Abstract

To establish the extent of varicocele as the cause of infertility in men and compare the various techniques of treatment. We searched PubMed and the Cochrane Library database using varicocele, male infertility, varicocelectomy as keywords. Varicocele seems to be a growing problem considered to be one of the most common causes of male infertility in recent times. Nevertheless, its role remains unclear. The best treatment option seems to be microscopic surgery - the most effective and linked to rare surgical complications. But the greatest clinical problem remains the selection of patients to treat - recently it is believed that varicocelectomy is a possibly advisable option in patients with clinical varicocele and seminal parameter impairment [1]. More high-quality, multicenter, long-term randomized controlled trials (RCT's) are required to verify the findings.

Keywords: infertile; male infertility; pregnancy rate; varicocele; varicocelectomy.

Figure 1

Microsurgical varicocelectomy. Spermatic cord delivered to the operative field just before introducing microscope (own material).

Figure 2

Microsurgical varicocelectomy. Veins after isolation and suture ligation. Identified spermatic artery – marked with a different colour suture (own material).