Varicocele: pathophysiology, diagnosis, and reproductive outcomes of treatment
DOI:
https://doi.org/10.62059/LatArXiv.preprints.391Keywords:
Men, Young men, Fertility, VaricoceleAbstract
Introduction: Varicocele is an abnormal dilation of the veins of the pampiniform plexus, common in young men, associated with male infertility due to its impact on spermatogenesis. Its prevalence increases with age and is usually asymptomatic, although it can cause testicular pain. Objective: To analyze the pathophysiology, diagnosis, and treatment of varicocele, evaluating its impact on male fertility. Methodology: A narrative review was conducted by searching PubMed, Scopus, and Scielo, including articles from 2020 to 2025, in English and Spanish, focused on the diagnosis and management of varicocele. Results: Varicocele affects up to 35% of men with primary infertility. Doppler ultrasound complements the physical examination for diagnosis. Management is conservative in asymptomatic cases and surgical in the presence of seminal abnormalities or persistent pain. The most effective techniques are subinguinal microsurgical varicocelectomy and laparoscopic varicocelectomy. An improvement of up to 80% in postoperative fertility and increases in testicular volume and semen quality were observed. Discussion: Evidence supports that oxidative stress and elevated testicular temperature are key mechanisms in sperm damage. Early diagnosis and individualized treatment are essential to improve reproductive prognosis. Advanced surgical techniques, such as robotics, offer advantages, although their use is limited. Conclusion: Appropriate management of varicoceles can reverse infertility in many cases. A comprehensive clinical evaluation is essential to guide evidence-based therapeutic decisions.
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