Pathophysiology: None of the theories has been proved unquestionably, although an elevated heat effect caused by impaired circulation appears to be the most reproducible defect. Supporting this hypothesis is the fact that a varicocele created in an experimental animal led to poor sperm function with elevated intratesticular temperature. Although unproved, a varicocele may represent a progressive lesion that can have detrimental effects on testicular function.
Disease statistics: An estimated 19 per cent of couples in Canada have trouble conceiving, and male-factor infertility contributes in approximately half of all cases.
Treatment: Medical Therapy: No effective medical treatments for varicoceles have been identified. While some investigators are evaluating the role of antioxidants for the treatment of elevated levels of reactive oxygen species, this treatment approach is still experimental. Surgical Therapy: The primary form of treatment for varicoceles is surgery. The Primary goals of varicocele repair should include occlusion of the offending varicosity with high success, preservation of arterial flow to the testis, and the minimization of patient discomfort and morbidity.
Research: Varicocele remains the most commonly identified correctable cause of male factor infertility. Surgical correction is the most commonly performed technique to treat varicoceles with a technical failure rate of less than 5%. An attractive alternative to surgery is the selective catheterization and embolization of the gonadal vein.