Comparative study between the outcome of endovascular treatment of varicocele with cyanoacrylate glues and surgical varicocelectomy

Abstract

Varicocele is a disorder characterized by dilated, tortuous veins within the pampiniform plexus of veins in the scrotum. It is a relatively common condition, representing in about 35% of males with primary infertility and 75–81% of males with secondary infertility. It is obviously recognized that the existence of varicocele is linked to an increased risk of change of sperm parameters, though the mechanisms have not yet been completely confirmed, it is considered to be multifactorial. The point that varicocele lead to higher levels of reactive oxygen species (ROS) was confirmed by recent studies which in turn results in sperm DNA fragmentation, leading to inadequate sperm function and fertilization outcome caused by varicocele. The etiology of varicocele is considered to be multifactorial. The anatomical differences between the left and right internal spermatic veins (causing the predominance of left-sided varicocele), the incompetence of the valves of the veins resulting in reflux of venous blood and the nutcracker phenomenon are the most popular theories. Clinical varicoceles can be detected by physical examination, whereas subclinical varicoceles can be only diagnosed by imaging, such as Duplex ultrasound. Differentiation between primary varicoceles and secondary varicoceles that are caused by external