[Varicocele and male infertility].

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  • Author(s): Huyghe E;Huyghe E;Huyghe E;Huyghe E; Methorst C; Methorst C; Faix A; Faix A
  • Source:
    Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie [Prog Urol] 2023 Nov; Vol. 33 (13), pp. 624-635.
  • Publication Type:
    Review; English Abstract; Journal Article
  • Language:
    French
  • Additional Information
    • Transliterated Title:
      Varicocèle et infertilité masculine.
    • Source:
      Publisher: Progrès en urologie, S.A.R.L Country of Publication: France NLM ID: 9307844 Publication Model: Print Cited Medium: Internet ISSN: 1166-7087 (Print) Linking ISSN: 11667087 NLM ISO Abbreviation: Prog Urol Subsets: MEDLINE
    • Publication Information:
      Publication: Paris : Progrès en urologie, S.A.R.L
      Original Publication: Paris : F.I.I.S.,
    • Subject Terms:
      Varicocele*/complications ; Varicocele*/surgery ; Infertility, Male*/etiology ; Infertility, Male*/therapy; Pregnancy ; Female ; Male ; Humans ; Semen ; Pregnancy Rate ; Vascular Surgical Procedures/adverse effects ; Sperm Count
    • Abstract:
      Background: Varicocele is the most common correctable cause of male infertility. It was the subject of recent Association française d'urologie (AFU) Comité d'andrologie et de médecine sexuelle (CAMS) recommendations. Since then, the literature has provided additional information. This review will comprehensively reassess current indications for the treatment of varicocele, and revisit contemporary issues in the light of current advances.
      Methods: Update of the literature search carried out as part of the CAMS recommendations for the period between 2020 and 2023.
      Results: Microsurgical sub-inguinal varicocelectomy remains the surgical treatment of choice for infertile men with clinical varicocele and abnormal sperm parameters. It offers recurrence rates of less than 4%. It significantly improves both natural and in vitro fertilization live birth and pregnancy rates, as well as sperm count, total and progressive motility, morphology and DNA fragmentation rates. All in all, it modifies the MPA strategy in around one in two cases. Varicocele grade and bilaterality are predictive of improved sperm parameters and pregnancy rate. Treatment of subclinical varicocele is not recommended. Complications are rare, notably hydroceles (0.5%), unilateral testicular atrophy due to arterial damage (1/1000), hematomas, delayed healing and postoperative pain. Retrograde embolization is an alternative to surgery.
      Conclusion: Whenever possible, the urologist should present and discuss treatment options for varicocele with the MPA team and the patient, taking a personalized approach.
      (Copyright © 2023. Published by Elsevier Masson SAS.)
    • Contributed Indexing:
      Keywords: Aide médicale à la procréation; Chirurgie; Embolisation; Embolization; Grossesse; Medically assisted reproduction; Pregnancy; Surgery; Varicocele; Varicocèle
    • Publication Date:
      Date Created: 20231128 Date Completed: 20231129 Latest Revision: 20231129
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.purol.2023.09.003
    • Accession Number:
      38012908