Adult varicocele.
OBJECTIVE
Adult varicocele presents a challenge for male reproductive specialists. We have yet to fully elucidate the pathophysiology of varicocele. The enigma of the varicocele, although a source of frustration for clinicians, has been a siren call for researchers as attested to by the substantial, if flawed body of literature on the topic. We critically review recent publications on varicocele.


RESULTS
Although yielding mixed results, studies this year have explored the potential relationship between oxidative stress and varicocele-associated infertility. In clinically focused research, one group tackled the contentious question of efficacy of surgical varicocele management. Building on the errors of prior meta-analyses, this study takes a fresh view on an old but vital topic. Finally, it is becoming clearer that varicocele affects Leydig cell function as well as seminiferous tubular function, and is a risk factor for androgen deficiency.


CONCLUSIONS
With exceptions, recent studies support a role for varicocelectomy in the management of infertile couples. In addition, evidence is accumulating that early repair of varicoceles, especially large varicoceles, may be effective in preventing future infertility and may be an effective treatment for androgen deficiency.
Kim
Howard H
HH
Department of Urology and Institute for Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA.
Goldstein
Marc
M
D000328:Adult; D005260:Female; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy; D008297:Male; D018384:Oxidative Stress; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male; D014646:Varicocele / Q000150:complications / Q000503:physiopathology / Q000601:surgery