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Chapter 15 - The Varicocele – Approaches to Diagnosis and Management

from Section 2 - Clinical Evaluation of the Infertile Male

Published online by Cambridge University Press:  08 July 2023

By
Sarah C. Krzastek ,
Ryan P. Smith  and
Stuart S. Howards
Edited by
Larry I. Lipshultz ,
Stuart S. Howards ,
Craig S. Niederberger  and
Dolores J. Lamb
Larry I. Lipshultz
Affiliation:
Baylor College of Medicine, Texas
Stuart S. Howards
Affiliation:
University of Virginia
Craig S. Niederberger
Affiliation:
University of Illinois, Chicago
Dolores J. Lamb
Affiliation:
Weill Cornell Medical College, New York
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Summary

A varicocele is an abnormal dilation of the veins within the testicular pampiniform plexus. Varicoceles can be found in approximately 15 percent of the general male population and are more prevalent in men presenting with subfertility or infertility [1, 2]. Forty percent of men being evaluated for infertility may be found to have a varicocele, and varicoceles have been implicated in as many as 80 percent of men presenting with secondary infertility [2, 3]. In fact, varicoceles remain the most common reversible cause of male infertility [4]. Additionally, the inheritance of varicoceles may be genetically linked, as 56 percent of men with a first-degree relative diagnosed with a known varicocele will also have a varicocele, independent of varicocele grade or laterality [5]. With the large variability in varicocele phenotype, biomarkers to predict the development and clinical outcomes of a varicocele do not yet currently exist. However, with the advent of next-generation sequencing, studies are being conducted to identify the genetic and epigenetic changes associated with varicoceles in hopes of early detection and treatment of patients who may benefit from varicocele intervention [6].

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Infertility in the Male , pp. 253 - 276
Publisher: Cambridge University Press
Print publication year: 2023

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References

Further Reading

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Silay, MS, Hoen, L, Quadackaers, J, et al. Treatment of varicocele in children and adolescents: a systematic review and meta-analysis from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel. Eur Urol 2019;75:448–61.Google Scholar

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