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27 results

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Infertility in the Male
  • 5th edition
  • Edited by Larry I. Lipshultz, Stuart S. Howards, Craig S. Niederberger, Dolores J. Lamb
  • Published online:
    08 July 2023
    Print publication:
    15 June 2023
  • This gold standard text has kept its readers abreast of rapid advancements in reproductive medicine and surgery since 1983. Continuing this tradition, this fifth edition has been fully updated and revised to provide clear, didactic advice on best practice for a variety of clinical situations faced by practitioners across many specialties - including urologists, gynecologists, reproductive endocrinologists, medical endocrinologists and many in internal medicine and family practice who see men with suboptimal fertility and reproductive problems. Completely restructured to include pedagogical features such as easily accessible key concepts that cement understanding and real-world use. Covering everything from foundations of anatomy and embryology, through clinical evaluation, diagnostic approaches, treatment and fertility care in context within the healthcare system and society, thrilling advances and future directions are also included. This new edition is an essential reference for all who are working in this young and rapidly evolving field.

  • Chapter 15 - The Varicocele – Approaches to Diagnosis and Management

  • from Section 2 - Clinical Evaluation of the Infertile Male
  • Edited by Larry I. Lipshultz, Baylor College of Medicine, Texas, Stuart S. Howards, University of Virginia, Craig S. Niederberger, University of Illinois, Chicago, Dolores J. Lamb, Weill Cornell Medical College, New York
  • Book:
    Infertility in the Male
    Published online:
    08 July 2023
    Print publication:
    15 June 2023, pp 253-276

  • Summary

    A varicocele is an abnormal dilation of the veins within the testicular pampiniform plexus. Varicoceles can be found in approximately 15 percent of the general male population and are more prevalent in men presenting with subfertility or infertility [1, 2]. Forty percent of men being evaluated for infertility may be found to have a varicocele, and varicoceles have been implicated in as many as 80 percent of men presenting with secondary infertility [2, 3]. In fact, varicoceles remain the most common reversible cause of male infertility [4]. Additionally, the inheritance of varicoceles may be genetically linked, as 56 percent of men with a first-degree relative diagnosed with a known varicocele will also have a varicocele, independent of varicocele grade or laterality [5]. With the large variability in varicocele phenotype, biomarkers to predict the development and clinical outcomes of a varicocele do not yet currently exist. However, with the advent of next-generation sequencing, studies are being conducted to identify the genetic and epigenetic changes associated with varicoceles in hopes of early detection and treatment of patients who may benefit from varicocele intervention [6].

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