Varicocele

Abstract

Varicocele is defined as a palpable dilated, elongated, and tortuous pampiniform plexus of veins draining the testis. The prevalence of varicocele is high with about 20% of men and increased in patients with primary infertility to 35%. The evidence-based recommendations for management of varicocele are under constant modification. There is no consensus for management of infertile men presenting with varicocele. This can be explained by absence of clear diagnostic criteria for varicocele that requires treatment, emerging of different varicocelectomy techniques with different outcomes, and the complex nature of couple infertility. This chapter aims to provide a concise review of epidemiology, pathophysiology, and diagnosis of varicocele. It focuses on fertility and endocrine disturbances associated with the condition, in addition to outlining the updated best practice in management of infertile varicocele patients with brief description of all management modalities. The role of varicocele repair in azoospermia, adolescents, and candidates for assisted reproductive techniques are also highlighted besides etiology and management of recurrent varicocele.