Fast Five Quiz: Test Your Knowledge of Varicoceles

Bradley Schwartz, DO

Disclosures

March 06, 2018

Ipsilateral testicular growth retardation is the most frequent relative indication for varicocele repair in adolescents; the concern is that patients with varicocele and ipsilateral testicular growth retardation at that age may manifest impaired fertility in adulthood.

A varicocele is an anatomic abnormality that can impair sperm production and function. No effective medical treatments for varicoceles have been identified. Although some investigators are evaluating the role of antioxidants for the treatment of elevated levels of reactive oxygen species, this treatment approach is still experimental.

Opinions vary regarding the value of repairing subclinical varicoceles in infertile men, but most experts do not recommend it. A 2014 committee opinion of the American Society for Reproductive Medicine and the Society for Male Reproduction and Urology advises that varicocele treatment is not indicated in patients with subclinical varicocele or in those with either normal semen quality or isolated teratozoospermia.

Varicocele ligation in a healthy patient has no specific contraindications, but various surgical approaches offer different advantages, and certain procedures should be avoided in specific settings. In addition, discovery of a varicocele at the time of vasectomy or vasectomy reversal is a relative contraindication to immediate repair. A 6-month delayed repair is recommended to allow the development of collateral vessels in order to decrease the chance of vascular compromise to the testicle.

For more on the treatment of varicocele, read here.

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