Role of Varicocele Sclerotherapy in the Management of Benign Prostatic Hyperplasia and its Associated Lower Urinary Tract Symptoms

Abstract

So far, varicocele has been studied for its etiologic role in male infertility yet literature to date shows anatomical and haemodynamic associations between varicocele and BPH via their connected venous plexuses that transmit changes in their hydrostatic pressures using fluid mechanics laws. The process is referred to as the “backdoor” phenomenon between testicles and prostate which seems to be of a clinical significance in middle-aged and elderly patients with BPH. Our study suggests that varicoceles are a contributing factor in the development of BPH in middle-aged & elderly men; however, it is still questionable whether varicoceles act alone or as a part of a systemic disorder to develop BPH. Future research should be directed towards the verification of the causal relationship between varicoceles and BPH. Long-term results and pathophysiologic mechanisms need to be further elucidated by a sufficient number of studies. Interventional occlusion of the spermatic veins in patients with BPH is a feasible outpatient minimally invasive procedure with a low complication rate and satisfactory short term results. Varicoceles sclerotherapy acts as a mechanical antidote to the mechanical testicular venous valvular failure and can be employed in the mitigation of the severity of the BPH-related lower urinary tract symptoms; lessening the need for prostatic surgeries and thus impacting the BPH management.