Varicocele

Abstract

The pampiniform plexus is a venous network that drains blood from the testis. A varicocele is an abnormal dilatation of the pampiniform plexus and usually occurs on the left side. The incidence of varicocele is almost as high as 15 % in the general population afflicting up to 35 % of men with primary infertility and 81 % of men with secondary infertility. Although other studies have found an equal incidence of varicocele among both primary and secondary infertility, this discrepancy remains to be explored (Jarow et al. 1996a, b; Gorelick and Goldstein 1993; Saypol 1981). A recent Cochrane review suggested that varicocele is the most frequent physical abnormality found in subfertile men (Kroese et al. 2012). The varicocele has always been a controversial topic and highly debated among specialists in the field. The effect of varicocele on semen parameters, its association with infertility, and its effect on pregnancy rates have been avidly debated. Subfertile men show a higher incidence of varicocele prompting researchers to believe that the varicocele is a cause of infertility (WHO 1992). Further, repair of varicocele has seemingly documented some beneficial effects (Newton et al. 1980). However, critics are skeptical as the effects of varicocele repair are inconsistent across studies.