Varicocele Questions & Answers

1. Lomboy JR, Coward RM. The Varicocele: Clinical Presentation, Evaluation, and Surgical Management. Semin Intervent Radiol. 2016 Sep. 33 (3):163-9. [QxMD MEDLINE Link].

2. Marte A. The history of varicocele: from antiquity to the modern ERA. Int Braz J Urol. 2018 May-Jun. 44 (3):563-576. [QxMD MEDLINE Link]. [Full Text].

3. Leslie SW, Sajjad H, Siref LE. Varicocele. 2023 Jan. [QxMD MEDLINE Link]. [Full Text].

4. Gat Y, Bachar GN, Zukerman Z, Belenky A, Gornish M. Varicocele: a bilateral disease. Fertil Steril. 2004 Feb. 81(2):424-9. [QxMD MEDLINE Link].

5. Brannigan RE. Introduction: Varicoceles: a contemporary perspective. Fertil Steril. 2017 Sep. 108 (3):361-363. [QxMD MEDLINE Link].

6. Witt MA, Lipshultz LI. Varicocele: a progressive or static lesion?. Urology. 1993 Nov. 42(5):541-3. [QxMD MEDLINE Link].

7. Paick S, Choi WS. Varicocele and Testicular Pain: A Review. World J Mens Health. 2018 May 16. [QxMD MEDLINE Link]. [Full Text].

8. Bogaert G, Orye C, De Win G. Pubertal screening and treatment for varicocele do not improve chance of paternity as adult. J Urol. 2013 Jun. 189(6):2298-303. [QxMD MEDLINE Link].

9. Chen SS, Chen LK. Risk factors for progressive deterioration of semen quality in patients with varicocele. Urology. 2012 Jan. 79(1):128-32. [QxMD MEDLINE Link].

10. Practice Committee of the American Society for Reproductive Medicine., Society for Male Reproduction and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril. 2014 Dec. 102 (6):1556-60. [QxMD MEDLINE Link]. [Full Text].

11. [Guideline] Jungwirth A, Diemer T, Dohle GR, Giwercman A, Kopa Z, Krausz C, et al. Guidelines on Male Infertility. European Association of Urology. Available at https://uroweb.org/guideline/male-infertility/. 2018; Accessed: April 7, 2021.

12. Condorelli RA, Calogero AE, Mongioi' L, Vicari E, Russo GI, Lanzafame F, et al. Varicocele and concomitant dilation of the periprostatic venous plexus: effects on semen viscosity sperm parameters. J Endocrinol Invest. 2015 Oct 30. [QxMD MEDLINE Link].

13. Sack BS, Schäfer M, Kurtz MP. The Dilemma of Adolescent Varicoceles: Do They Really Have to Be Repaired?. Curr Urol Rep. 2017 May. 18 (5):38. [QxMD MEDLINE Link]. [Full Text].

14. Casey JT, Misseri R. Adolescent Varicoceles and Infertility. Endocrinol Metab Clin North Am. 2015 Dec. 44 (4):835-42. [QxMD MEDLINE Link].

15. Lipshultz LI, Corriere JN Jr. Progressive testicular atrophy in the varicocele patient. J Urol. 1977 Feb. 117(2):175-6. [QxMD MEDLINE Link].

16. Diamond DA, Zurakowski D, Atala A, Bauer SB, Borer JG, Cilento BG Jr, et al. Is adolescent varicocele a progressive disease process?. J Urol. 2004 Oct. 172(4 Pt 2):1746-8; discussion 1748. [QxMD MEDLINE Link].

17. Kass EJ, Belman AB. Reversal of testicular growth failure by varicocele ligation. J Urol. 1987 Mar. 137(3):475-6. [QxMD MEDLINE Link].

18. McClure RD, Khoo D, Jarvi K, Hricak H. Subclinical varicocele: the effectiveness of varicocelectomy. J Urol. 1991 Apr. 145(4):789-91. [QxMD MEDLINE Link].

19. Tsili AC, Sofikitis N, Xiropotamou O, Astrakas LG, Ntorkou A, Argyropoulou MI. Diffusion tensor imaging as an adjunct tool for the diagnosis of varicocele. Andrologia. 2018 Dec 16. e13210. [QxMD MEDLINE Link].

20. Çekiç B, Kiliç KK, Toslak IE, Şükun A, Sağlik S, Savaş M, et al. Correlation Between Semen Analysis Parameters and Diffusion-Weighted Magnetic Resonance Imaging of the Testicles in Patients With Varicocele: A Pilot Study. J Comput Assist Tomogr. 2018 May/Jun. 42 (3):423-428. [QxMD MEDLINE Link].

21. Emad-Eldin S, Salim AMA, Wahba MH, Elahwany AT, Abdelaziz O. The use of diffusion-weighted MR imaging in the functional assessment of the testes of patients with clinical varicocele. Andrologia. 2018 Nov 20. e13197. [QxMD MEDLINE Link].

22. Arab D, Doustmohammadi H, Ardestani Zadeh A. Dietary supplements in the management of varicocele-induced infertility: A review of potential mechanisms. Andrologia. 2021 Feb. 53 (1):e13879. [QxMD MEDLINE Link].

23. Ioannidou PG, Papanikolaou DA, Bosdou JK, Goulis DG, Lambropoulos AF, Grimbizis GF, et al. Improvement in sperm quality by oral antioxidant supplementation in infertile men with varicocele who have not undergone surgical repair: Systematic review and meta-analysis. Andrologia. 2022 Nov. 54 (10):e14533. [QxMD MEDLINE Link].

24. Bernie HL, Goldstein M. Varicocele Repair Versus Testosterone Therapy for Older Hypogonadal Men with Clinical Varicocele and Low Testosterone. Eur Urol Focus. 2018 Apr. 4 (3):314-316. [QxMD MEDLINE Link].

25. Abdel-Meguid TA, Al-Sayyad A, Tayib A, Farsi HM. Does Varicocele Repair Improve Male Infertility? An Evidence-Based Perspective From a Randomized, Controlled Trial. Eur Urol. 2010 Dec 21. [QxMD MEDLINE Link].

26. Owen RC, McCormick BJ, Figler BD, Coward RM. A review of varicocele repair for pain. Transl Androl Urol. 2017 May. 6 (Suppl 1):S20-S29. [QxMD MEDLINE Link]. [Full Text].

27. [Guideline] Methorst C, Akakpo W, Graziana JP, Ferretti L, Yiou R, Morel-Journel N, et al. [Recommendations of the Committee of Andrology and Sexual Medicine of the AFU concerning the management of Varicocele]. Prog Urol. 2021 Mar. 31 (3):119-130. [QxMD MEDLINE Link].

28. Yuan R, Zhuo H, Cao D, Wei Q. Efficacy and safety of varicocelectomies: A meta-analysis. Syst Biol Reprod Med. 2017 Apr. 63 (2):120-129. [QxMD MEDLINE Link].

29. Najari BB, Introna L, Paduch DA. Improvements in Patient Reported Sexual Function after Microsurgical Varicocelectomy. Urology. 2016 May 16. [QxMD MEDLINE Link].

30. Niu Y, Wang D, Chen Y, Pokhrel G, Xu H, Wang T, et al. Comparison of clinical outcome of bilateral and unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: A meta-analysis of randomised controlled trials. Andrologia. 2018 Nov. 50 (9):e13078. [QxMD MEDLINE Link].

31. Sun XL, Wang JL, Peng YP, Gao QQ, Song T, Yu W, et al. Bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: a prospective randomized controlled study. Int Urol Nephrol. 2018 Feb. 50 (2):205-210. [QxMD MEDLINE Link].

32. Bebi C, Bilato M, Minoli DG, De Marco EA, Gnech M, Paraboschi I, et al. Radiation Exposure and Surgical Outcomes after Antegrade Sclerotherapy for the Treatment of Varicocele in the Paediatric Population: A Single Centre Experience. J Clin Med. 2023 Jan 18. 12 (3):[QxMD MEDLINE Link]. [Full Text].

33. Chung KLY, Hung JWS, Yam FSD, Chao NSY, Li DCY, Leung MWY. Prospective Randomized Controlled Trial Comparing Laparoscopic Palomo Surgery vs Scrotal Antegrade Sclerotherapy in Adolescent Varicocele. J Urol. 2023 Mar. 209 (3):600-610. [QxMD MEDLINE Link].

34. Fabiani A, Pavia MP, Stramucci S, Antezza A, De Stefano V, Castellani D. Do sclero-embolization procedures have advantages over surgical ligature in treating varicocele in children, adolescents and adults? Results from a systematic review and meta-analysis. Andrologia. 2022 Sep. 54 (8):e14510. [QxMD MEDLINE Link].

35. Shibata Y, Kurihara S, Arai S, Kato H, Suzuki T, Miyazawa Y, et al. Efficacy of Indocyanine Green Angiography on Microsurgical Subinguinal Varicocelectomy. J Invest Surg. 2016 Oct 13. 1-5. [QxMD MEDLINE Link].

36. Rizkala E, Fishman A, Gitlin J, Zelkovic P, Franco I. Long term outcomes of lymphatic sparing laparoscopic varicocelectomy. J Pediatr Urol. 2013 Aug. 9(4):458-63. [QxMD MEDLINE Link].

37. Chan PT, Wright EJ, Goldstein M. Incidence and postoperative outcomes of accidental ligation of the testicular artery during microsurgical varicocelectomy. J Urol. 2005 Feb. 173(2):482-4. [QxMD MEDLINE Link].

38. Madgar I, Weissenberg R, Lunenfeld B, Karasik A, Goldwasser B. Controlled trial of high spermatic vein ligation for varicocele in infertile men. Fertil Steril. 1995 Jan. 63(1):120-4. [QxMD MEDLINE Link].

39. Vazquez-Levin MH, Friedmann P, Goldberg SI, Medley NE, Nagler HM. Response of routine semen analysis and critical assessment of sperm morphology by Kruger classification to therapeutic varicocelectomy. J Urol. 1997 Nov. 158(5):1804-7. [QxMD MEDLINE Link].

40. Agarwal A, Cannarella R, Saleh R, et al. Impact of Varicocele Repair on Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis. World J Mens Health. 2023 Apr. 41 (2):289-310. [QxMD MEDLINE Link]. [Full Text].

41. Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet. 2003 May 31. 361(9372):1849-52. [QxMD MEDLINE Link].

42. Grober ED, Chan PT, Zini A, Goldstein M. Microsurgical treatment of persistent or recurrent varicocele. Fertil Steril. 2004 Sep. 82(3):718-22. [QxMD MEDLINE Link].

43. Schlegel PN. Is assisted reproduction the optimal treatment for varicocele-associated male infertility? A cost effective analysis. Urology. 1997. 49:83-90. [QxMD MEDLINE Link].

44. Gal J, Goldstein M. The contemporary role of varicocele repair: why operate when in-vitro fertilization results are so good?. Curr Opin Urol. 2023 Jan 1. 33 (1):1-4. [QxMD MEDLINE Link].

45. Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016 Aug 12. [QxMD MEDLINE Link].

46. Shabana W, Teleb M, Dawod T, Elsayed E, Desoky E, Shahin A, et al. Predictors of improvement in semen parameters after varicocelectomy for male subfertility: A prospective study. Can Urol Assoc J. 2015 Sep-Oct. 9 (9-10):E579-82. [QxMD MEDLINE Link]. [Full Text].

Wesley M White, MD Chair, Associate Professor, Director of Laparoscopic and Robotic Urologic Surgery, Department of Urology, University of Tennessee Graduate School of Medicine

Wesley M White, MD is a member of the following medical societies: American Urological Association, Endourological Society, Society of Academic Urologists, Society of Urologic Oncology, Southeastern Section of the American Urological Association (AUA), Tennessee Medical Association, Tennessee Urological Association

Disclosure: Nothing to disclose.

Joe D Mobley, III, MD, MPH Urologist, Kentucky Lake Urology Clinic

Joe D Mobley, III, MD, MPH is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Endourological Society, Tennessee Medical Association

Disclosure: Nothing to disclose.

Edward David Kim, MD, FACS Professor of Urology, Department of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American Society for Reproductive Medicine, American Urological Association, Sexual Medicine Society of North America, Society for Male Reproduction and Urology, Society for the Study of Male Reproduction, Tennessee Medical Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Endo, Antares.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Mark Jeffrey Noble, MD Consulting Staff, Urologic Institute, Cleveland Clinic Foundation

Mark Jeffrey Noble, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Kansas Medical Society, Sigma Xi, The Scientific Research Honor Society, Society of University Urologists, SWOG

Disclosure: Nothing to disclose.

Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoscopic and Robotic Surgeons, Society of University Urologists

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Endourological Society Board of Directors; President Elect North Central Section of the American Urological Association<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cook Medical.

Gamal Mostafa Ghoniem, MD, FACS Professor and Vice Chair of Urology, Chief, Division of Female Urology, Pelvic Reconstructive Surgery, and Voiding Dysfunction, Department of Urology, University of California, Irvine, School of Medicine

Gamal Mostafa Ghoniem, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urogynecologic Society, American Urological Association, International Continence Society, International Urogynaecology Association, Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Astellas<br/>Received research grant from: Uroplasty/Cogentix, Astellas, Allergen.

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