Varicocele is prevalent in infertile individuals as well as in normal adolescents and adults.It has an increasing trend with growing age.Infertile individuals with varicocele,develop varying degrees of sperm abnormali...Varicocele is prevalent in infertile individuals as well as in normal adolescents and adults.It has an increasing trend with growing age.Infertile individuals with varicocele,develop varying degrees of sperm abnormalities that range from mild to severe semen abnormalities,even azoospermia may develop.The main proposed features of these abnormalities are incompetence of one-way valves of the draining veins of testes,that allow backflow of blood into testes.This backflow produces abnormally high intra-testicular pressure and temperature,that has been confirmed by thermography and pressure estimation in various studies.Microsurgical varicocelectomy may reverse the pathologic effects on spermatogenesis in most patients,which points towards the cause and effect relationship of varicocele with testicular damage.We propose that the prolonged effect of gravity might or may not be the initiating factor for varicocele,as in our experience,around 1/4th of hypogonadotropic hypogonadism patients who had no varicocele before treatment,developed varicocele within 3 to 6 mo of treatment with gonadotropins.Occasionally varicocele is produced by"Nutcrackerphenomenon",which is compression of left renal vein between the abdominal aorta and superior mesenteric artery.The deleterious effects of varicocele may develop slowly,causing delayed secondary infertility or rapidly,leading to azoospermia or individual may be spared of damage due to unknown factors that need further research.展开更多
文摘Varicocele is prevalent in infertile individuals as well as in normal adolescents and adults.It has an increasing trend with growing age.Infertile individuals with varicocele,develop varying degrees of sperm abnormalities that range from mild to severe semen abnormalities,even azoospermia may develop.The main proposed features of these abnormalities are incompetence of one-way valves of the draining veins of testes,that allow backflow of blood into testes.This backflow produces abnormally high intra-testicular pressure and temperature,that has been confirmed by thermography and pressure estimation in various studies.Microsurgical varicocelectomy may reverse the pathologic effects on spermatogenesis in most patients,which points towards the cause and effect relationship of varicocele with testicular damage.We propose that the prolonged effect of gravity might or may not be the initiating factor for varicocele,as in our experience,around 1/4th of hypogonadotropic hypogonadism patients who had no varicocele before treatment,developed varicocele within 3 to 6 mo of treatment with gonadotropins.Occasionally varicocele is produced by"Nutcrackerphenomenon",which is compression of left renal vein between the abdominal aorta and superior mesenteric artery.The deleterious effects of varicocele may develop slowly,causing delayed secondary infertility or rapidly,leading to azoospermia or individual may be spared of damage due to unknown factors that need further research.
