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Varicocele Treatment
V
aricocele is an anatomoclinical syndrome characterized by dilation of the venous plexus and clinically by spermatic venous reflux into the veins of the pampiniform plexus that drain the blood from the testicles. The presence of these testicular varices has been related to male infertility, more specifically, with a decrease in the number of spermatozoa, their mobility, morphology, and capacity for fertilization.
Treatment
The aim of varicocele correction is to improve the reproductive capacity of the patient, improve the production of androgens and in cases of testicular pain, its suppression.
In the cases of men with infertility and varicocele surgery is not always necessary.
Assisted Reproduction Techniques such as ICSI, intrauterine insemination can be the way to achieve a pregnancy. But in most cases, the correction allows a greater chance of getting this.
The treatment for varicocele can be surgical or by embolization. To decide
what kind of access is going to be carried out, it is necessary to keep in mind the three types of varicocele formation pathways: failure of the internal spermatic vein, hyperpressure of the primitive iliac vein and anomalies of the venous plexuses.
Regarding the embolization of the testicular veins, it can be of two forms: antegrade by scrotal via or retrograde via the femoral vein. Other forms of intervention are sclerotherapy and surgery for laparoscopy, which has a high cost, and the microscopic, which is the lowest rate of recurrence presents.
The prognostic factors in the adult are related to the age of the couple and their fertility status, the presence of other associated pathologies such as infections, obesity, toxic consumption, etc., the time of infertility, the degree of spermogram and the levels of FSH, LH and androgens.
Among the most important beneficial changes of the varicocele correction is the recovery of testicular volume, which occurs in 70-80% of adolescents in which the testicular size was inferior to normal. It has also been found an increase in testosterone concentration and in the quality of the semen when they are compared with the non-operated patients.