Varicocele: How this condition and its management affects men's health

Abstract

Varicocele is a relatively common condition that can impact men’s health in various ways. Unfortunately, its prevalence and the availability of various different methods of repairing it might lead to unnecessary treatment. An understanding of the various ways that this condition can impact men’s health is necessary in order to manage it appropriately. At present, there is substantial evidence to support varicocele repair in men who present with infertility, abnormal semen parameters, clinical varicocele and a female partner with normal fertility (or one with a potentially correctable abnormality). Varicocele repair appears to improve seminal fluid quality and might improve pregnancy rates. It might also have a role in managing men with non-obstructive azoospermia. Varicocele can also be a cause of scrotal pain that is usually of a dull character. Varicocele repair is an effective method of managing this type of pain, especially once proper measures have been taken to exclude other possible causes of orchalgia. Conservative measures are generally not effective in managing varicocele-related scrotal pain. There is growing evidence to suggest that varicocele repair might have a role in improving the serum testosterone level in men with hypogonadism, especially in the subfertile population. Well-designed prospective studies are needed to support the utilization of varicocele repair in managing these patients, as well as in preventing testicular dysfunction on a prophylactic basis.

Keywords: Varicocele, Varicocelectomy, Infertility, Azoospermia, Pain

Core tip: The prevalence of varicocele and the availability of various different methods of repairing it might lead to unnecessary treatment. An understanding of the various ways that this condition can impact men’s health is necessary in order to manage it appropriately. An overview of this disorder is given, together with different indications of treating it in adult men.