Varicocele as a progressive lesion: positive effect of varicocele repair

Varicoceles are the leading correctable cause of infertility in men who pre sent to an infertility clinic for evaluation. Consequently, the surgical co rrection of a varicocele, known as a varicocelectomy, is the most commonly performed operation for the treatment of male infertility, The current data suggest that an individual with a varicocele, even with a previously norma l semen analysis or documentation of previous fertility, is at risk for sub sequent loss of testicular function and infertility, Many of these patients will need to be treated because there is convincing evidence that a varico cele may have a progressive toxic effect on the testes that may ultimately result in irreversible infertility if left untreated, Identifying those ind ividuals with varicoceles that will ultimately cause fertility impairment i s still beyond our current clinical capabilities. Current investigative mod alities, e.g. semen analysis, testicular measurement, serum gonadotrophin d etermination, gonadotrophin-releasing hormone (GnRH) stimulation test, and testis biopsy analysis, may be employed to detect early changes in testicul ar physiology produced by a varicocele.