Varicocele

Brannigan RE, Hermanson L, Kaczmarek J, et al. Updates to male infertility: AUA/ASRM guideline (2024). J Urol. 2024 Dec;212(6):789-99. Abstract

European Association of Urology. Sexual and reproductive health guidelines. Apr 2025 [internet publication].Full text

Persad E, O'Loughlin CA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021 Apr 23;4:CD000479.Full text  Abstract

European Association of Urology. Guidelines on paediatric urology. Apr 2024 [internet publication].Full text

1. Clavijo RI, Carrasquillo R, Ramasamy R. Varicoceles: prevalence and pathogenesis in adult men. Fertil Steril. 2017 Sep;108(3):364-9.Full text  Abstract

2. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril. 1970 Aug;21(8):606-9.Full text

3. Diamond DA. Adolescent varicocele: emerging understanding. BJU Int. 2003 Oct;92 Suppl 1:48-51. Abstract

4. Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet. 2003 May 31;361(9372):1849-52. Abstract

5. Steeno O, Knops J, Declerck L, et al. Prevention of fertility disorders by detection and treatment of varicocele at school and college age. Andrologia. 1976;8(1):47-53. Abstract

6. Kumanov P, Robeva RN, Tomova A. Adolescent varicocele: who is at risk? Pediatrics. 2008 Jan;121(1):e53-7. Abstract

7. Sylora JA, Pryor JL. Varicocele. Curr Ther Endocrinol Metab. 1994;5:309-14. Abstract

8. Green KF, Turner TT, Howards SS. Varicocele: reversal of the testicular bloodflow and temperature effects by varicocele repair. J Urol. 1984 Jun;131(6):1208-11. Abstract

9. World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril. 1992 Jun;57(6):1289-93. Abstract

10. Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertil Steril. 1993 Mar;59(3):613-6. Abstract

11. Vasavada S, Ross J, Nasrallah P, et al. Prepubertal varicoceles. Urology. 1997 Nov;50(5):774-7. Abstract

12. Prabakaran S, Kumanov P, Tomova A, et al. Adolescent varicocele: association with somatometric parameters. Urol Int. 2006;77(2):114-7. Abstract

13. Delaney DP, Carr MC, Kolon TF, et al. The physical characteristics of young males with varicocele. BJU Int. 2004 Sep;94(4):624-6. Abstract

14. May M, Taymoorian K, Beutner S, et al. Body size and weight as predisposing factors in varicocele. Scand J Urol Nephrol. 2006;40(1):45-8. Abstract

15. Xiao-Bin G, Fang-Lei W, Hui X, et al. The association between body mass index and varicocele: a meta-analysis. Int Braz J Urol. 2021 Jan-Feb;47(1):8-19.Full text  Abstract

16. Raman JD, Walmsley K, Goldstein M. Inheritance of varicoceles. Urology. 2005 Jun;65(6):1186-9. Abstract

17. Mohammadali Beigi F, Mehrabi S, Javaherforooshzadeh A. Varicocele in brothers of patients with varicocele. Urol J. 2007 Winter;4(1):33-5. Abstract

18. Mokhtari G, Pourreza F, Falahatkar S, et al. Comparison of prevalence of varicocele in first-degree relatives of patients with varicocele and male kidney donors. Urology. 2008 Apr;71(4):666-8. Abstract

19. Sigmund G, Gall H, Bahren W. Stop-type and shunt-type varicoceles: venographic findings. Radiology. 1987 Apr;163(1):105-10. Abstract

20. Bong GW, Koo HP. The adolescent varicocele: to treat or not to treat. Urol Clin North Am. 2004 Aug;31(3):509-15. Abstract

21. Wishahi MM. Anatomy of the spermatic venous plexus (pampiniform plexus) in men with and without varicocele: intraoperative venographic study. J Urol. 1992 May;147(5):1285-9. Abstract

22. Cho CL, Esteves SC, Agarwal A. Novel insights into the pathophysiology of varicocele and its association with reactive oxygen species and sperm DNA fragmentation. Asian J Androl. 2016 Mar-Apr;18(2):186-93.Full text  Abstract

23. Paduch DA, Niedzielski J. Semen analysis in young men with varicocele: preliminary study. J Urol. 1996 Aug;156(2 Pt 2):788-90. Abstract

24. Macey MR, Owen RC, Ross SS, et al. Best practice in the diagnosis and treatment of varicocele in children and adolescents. Ther Adv Urol. 2018 Jun 22;10(9):273-82.Full text  Abstract

25. Chung JM, Lee SD. Current issues in adolescent varicocele: pediatric urological perspectives. World J Mens Health. 2018 May;36(2):123-31.Full text  Abstract

26. Brannigan RE, Hermanson L, Kaczmarek J, et al. Updates to male infertility: AUA/ASRM guideline (2024). J Urol. 2024 Dec;212(6):789-99. Abstract

27. Elmer DeWitt M, Greene DJ, Gill B, et al. Isolated right varicocele and incidence of associated cancer. Urology. 2018 Jul;117:82-5.Full text  Abstract

28. Walker AR, Kogan BA. Cost-benefit analysis of scrotal ultrasound in treatment of adolescents with varicocele. J Urol. 2010 May;183(5):2008-11. Abstract

29. Freeman S, Bertolotto M, Richenberg J, et al. Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 2020 Jan;30(1):11-25.Full text  Abstract

30. Practice Committee of the American Society for Reproductive Medicine; Society for Male Reproduction and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril. 2014 Dec;102(6):1556-60.Full text  Abstract

31. Tanrikut C, Goldstein M, Rosoff JS, et al. Varicocele as a risk factor for androgen deficiency and effect of repair. BJU Int. 2011 Nov;108(9):1480-4.Full text  Abstract

32. European Association of Urology. Sexual and reproductive health guidelines. Apr 2025 [internet publication].Full text

33. Caliskan Z, Kucukgergin C, Aktan G, et al. Evaluation of sperm DNA fragmentation in male infertility. Andrologia. 2022 Dec;54(11):e14587. Abstract

34. Persad E, O'Loughlin CA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021 Apr 23;4:CD000479.Full text  Abstract

35. Qiu D, Shi Q, Pan L. Efficacy of varicocelectomy for sperm DNA integrity improvement: a meta-analysis. Andrologia. 2021 Feb;53(1):e13885. Abstract

36. Li F, Yamaguchi K, Okada K, et al. Significant improvement of sperm DNA quality after microsurgical repair of varicocele. Syst Biol Reprod Med. 2012 Oct;58(5):274-7.Full text  Abstract

37. Birowo P, Tendi W, Widyahening IS, et al. The benefits of varicocele repair for achieving pregnancy in male infertility: a systematic review and meta-analysis. Heliyon. 2020 Nov 5;6(11):e05439.Full text  Abstract

38. Shah R, Agarwal A, Kavoussi P, et al. Consensus and diversity in the management of varicocele for male infertility: results of a global practice survey and comparison with guidelines and recommendations. World J Mens Health. 2023 Jan;41(1):164-97.Full text  Abstract

39. Birowo P, Rahendra Wijaya J, Atmoko W, et al. The effects of varicocelectomy on the DNA fragmentation index and other sperm parameters: a meta-analysis. Basic Clin Androl. 2020 Sep 10:30:15.Full text  Abstract

40. Punjani N, Wald G, Gaffney CD, et al. Predictors of varicocele-associated pain and its impact on semen parameters following microsurgical repair. Andrologia. 2021 Sep;53(8):e14121. Abstract

41. Diamond DA, Paltiel HJ, DiCanzio J, et al. Comparative assessment of pediatric testicular volume: orchidometer versus ultrasound. J Urol. 2000 Sep;164(3 Pt 2):1111-4. Abstract

42. Meacham RB, Townsend RR, Rademacher D, et al. The incidence of varicoceles in the general population when evaluated by physical examination, gray scale sonography and color Doppler sonography. J Urol. 1994 Jun;151(6):1535-8. Abstract

43. Kursh ED. What is the incidence of varicocele in a fertile population? Fertil Steril. 1987 Sep;48(3):510-1. Abstract

44. Bogaert G, Orye C, De Win G. Pubertal screening and treatment for varicocele do not improve chance of paternity as adult. J Urol. 2013 Jun;189(6):2298-303. Abstract

45. Bogaert GA. Adolescent varicocele: limited indications for treatment during puberty and adolescence. Transl Androl Urol. 2014 Dec;3(4):398-401.Full text  Abstract

46. Yuan R, Zhuo H, Cao D, et al. Efficacy and safety of varicocelectomies: a meta-analysis. Syst Biol Reprod Med. 2017 Apr;63(2):120-9.Full text  Abstract

47. Al-Kandari AM, Shabaan H, Ibrahim HM, et al. Comparison of outcomes of different varicocelectomy techniques: open inguinal, laparoscopic, and subinguinal microscopic varicocelectomy: a randomized clinical trial. Urology. 2007 Mar;69(3):417-20.Full text  Abstract

48. Al-Said S, Al-Naimi A, Al-Ansari A, Y, et al. Varicocelectomy for male infertility: a comparative study of open, laparoscopic and microsurgical approaches. J Urol. 2008 Jul;180(1):266-70. Abstract

49. Baazeem A, Belzile E, Ciampi A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol. 2011 Oct;60(4):796-808. Abstract

50. Ding H, Tian J, Du W, et al. Open non-microsurgical, laparoscopic or open microsurgical varicocelectomy for male infertility: a meta-analysis of randomized controlled trials. BJU Int. 2012 Nov;110(10):1536-42. Abstract

51. Cayan S, Shavakhabov S, Kadioğlu A. Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique. J Androl. 2009 Jan-Feb;30(1):33-40.Full text  Abstract

52. Tandon S, Bennett D, Mark Nataraja R, et al. Outcome following the surgical management of varicocele in children and adolescents: a systematic review and meta-analysis. Ther Adv Urol. 2023 Jan-Dec;15:17562872231206239.Full text  Abstract

53. Diamond DA, Zurakowski D, Atala A, et al. Is adolescent varicocele a progressive disease process? J Urol. 2004 Oct;172(4 pt 2):1746-8; discussion 1748. Abstract

54. European Association of Urology. Guidelines on paediatric urology. Apr 2024 [internet publication].Full text

55. Thomas JC, Elder JS. Testicular growth arrest and adolescent varicocele: does varicocele size make a difference? J Urol. 2002 Oct;168(4 Pt 2):1689-91. Abstract

56. Li F, Chiba K, Yamaguchi K, et al. Effect of varicocelectomy on testicular volume in children and adolescents: a meta-analysis. Urology. 2012 Jun;79(6):1340-5. Abstract

57. Owen RC, McCormick BJ, Figler BD, et al. A review of varicocele repair for pain. Transl Androl Urol. 2017 May;6(suppl 1):S20-9.Full text  Abstract

58. Laven JS, Haans LC, Mali WP, et al. Effects of varicocele treatment in adolescents: a randomized study. Fertil Steril. 1992 Oct;58(4):756-62. Abstract

59. Silay MS, Hoen L, Quadackaers J, et al. Treatment of varicocele in children and adolescents: a systematic review and meta-analysis from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel. Eur Urol. 2019 Mar;75(3):448-61.Full text  Abstract

60. Locke JA, Noparast M, Afshar K. Treatment of varicocele in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. J Pediatr Urol. 2017 Oct;13(5):437-45. Abstract

61. Esteves SC, Roque M, Agarwal A. Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic review and meta-analysis. Asian J Androl. 2016 Mar-Apr;18(2):254-8.Full text  Abstract

62. Kirby EW, Wiener LE, Rajanahally S, et al. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016 Nov;106(6):1338-43. Abstract

63. Practice Committee of the American Society for Reproductive Medicine. Management of nonobstructive azoospermia: a committee opinion. Fertil Steril. 2018 Dec;110(7):1239-45.Full text  Abstract

64. National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. Sep 2017 [internet publication].Full text

65. Asafu-Adjei D, Judge C, Deibert CM, et al. Systematic review of the impact of varicocele grade on response to surgical management. J Urol. 2020 Jan;203(1):48-56.Full text  Abstract

66. Chen X, Yang D, Lin G, et al. Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: a meta-analysis. Andrologia. 2017 Dec;49(10). Abstract

67. Schauer I, Madersbacher S, Jost R, et al. The impact of varicocelectomy on sperm parameters: a meta-analysis. J Urol. 2012 May;187(5):1540-7. Abstract

68. Esteves SC, Miyaoka R, Roque M, et al. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl. 2016 Mar-Apr;18(2):246-53.Full text  Abstract

69. Sajadi H, Hosseini J, Farrahi F, et al. Varicocelectomy may improve results for sperm retrieval and pregnancy rate in non-obstructive azoospermic men. Int J Fertil Steril. 2019 Jan;12(4):303-5.Full text  Abstract

70. Fallara G, Capogrosso P, Pozzi E, et al. The effect of varicocele treatment on fertility in adults: a systematic review and meta-analysis of published prospective trials. Eur Urol Focus. 2023 Jan;9(1):154-61. Abstract

71. Li F, Yue H, Yamaguchi K, et al. Effect of surgical repair on testosterone production in infertile men with varicocele: a meta-analysis. Int J Urol. 2012 Feb;19(2):149-54. Abstract

72. Wang YJ, Zhang RQ, Lin YJ, et al. Relationship between varicocele and sperm DNA damage and the effect of varicocele repair: a meta-analysis. Reprod Biomed Online. 2012 Sep;25(3):307-14. Abstract

73. Jensen CFS, Østergren P, Dupree JM, et al. Varicocele and male infertility. Nat Rev Urol. 2017 Sep;14(9):523-33. Abstract

74. Esposito C, Valla JS, Najmaldin A, et al. Incidence and management of hydrocele following varicocele surgery in children. J Urol. 2004 Mar;171(3):1271-3. Abstract

75. Misseri R, Gershbein AB, Horowitz M, et al. The adolescent varicocele. II: the incidence of hydrocele and delayed recurrent varicocele after varicocelectomy in a long-term follow-up. BJU Int. 2001 Apr;87(6):494-8. Abstract

76. Fast AM, Deibert CM, Van Batavia JP, et al. Adolescent varicocelectomy: does artery sparing influence recurrence rate and/or catch-up growth? Andrology. 2014 Mar;2(2):159-64.Full text  Abstract

77. Kim KS, Lee C, Song SH, et al. Impact of internal spermatic artery preservation during laparoscopic varicocelectomy on recurrence and the catch-up growth rate in adolescents. J Pediatr Urol. 2014 Jun;10(3):435-40. Abstract