Varicocele: Updated
Mahmoud Fawzy Fahim;
Abstract
Varicocele is a common cause of male infertility. The association •of varicocele with decreased testicular size,
. abnormal testicular histology and abnormal semen parameter is established.
The pathophysiology of the varicocele effect on fertility remains unclear. It includes renal adrenal reflux, alteration in the hypothalamo- pituitary gonadal axis, hypoxia, hyperthermia and formation of anti-protozoal antibodies.
Because the high incidence of bilateral varicocele and subclinical varicocele, scrotal Duplex sonography is helpful in establishing the diagnosis especially patients with subfertility. Duplex has proved to be easy, simple, unexpensive and widely spread test.
The options of therapy may be medical, surgical or radiological. The results of medical treatment are so inferior to surgical or radiological options . Frank indications for non conservative therapy are infertility and scrotal pain however controversially issues are still present in the management of two clinical situation viz.: adolescent varicocele, and asymptomatic cases showing varicocele but with normal seminal parameters as well as being free of pain .
Several surgical methods for the treatment of varicocele have been described.There are three basic surgical approaches to ligating the internal spermatic vein viz.
. abnormal testicular histology and abnormal semen parameter is established.
The pathophysiology of the varicocele effect on fertility remains unclear. It includes renal adrenal reflux, alteration in the hypothalamo- pituitary gonadal axis, hypoxia, hyperthermia and formation of anti-protozoal antibodies.
Because the high incidence of bilateral varicocele and subclinical varicocele, scrotal Duplex sonography is helpful in establishing the diagnosis especially patients with subfertility. Duplex has proved to be easy, simple, unexpensive and widely spread test.
The options of therapy may be medical, surgical or radiological. The results of medical treatment are so inferior to surgical or radiological options . Frank indications for non conservative therapy are infertility and scrotal pain however controversially issues are still present in the management of two clinical situation viz.: adolescent varicocele, and asymptomatic cases showing varicocele but with normal seminal parameters as well as being free of pain .
Several surgical methods for the treatment of varicocele have been described.There are three basic surgical approaches to ligating the internal spermatic vein viz.
Other data
| Title | Varicocele: Updated | Other Titles | الجديد فى دوالى الخصية | Authors | Mahmoud Fawzy Fahim | Issue Date | 2002 |
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