Journal Basic Info
- Impact Factor: 1.989**
- H-Index: 6
- ISSN: 2637-4625
- DOI: 10.25107/2637-4625
Major Scope
- Otolaryngology & ENT Surgery
- Ophthalmology
- Cardiothoracic Surgery
- Orthopaedic Surgery
- Emergency Surgery
- Pediatric Surgery
- Surgery & Surgical Research
- Hand Surgery
Abstract
Citation: World J Surg Surg Res. 2021;4(1):1281.DOI: 10.25107/2637-4625.1281
Subclinical Varicocele (SCV): What the Urologists Need to Know?
Ashwin Muthukumar, Hariharasudhan Sekar, Sriram Krishnamoorthy* and Natarajan Kumaresan
*Correspondance to: Sriram Krishnamoorthy
PDF Full Text Review Article | Open Access
Abstract:
Sub-Clinical Varicocele (SCV) is characterized by normal clinical examination and diagnosed
mainly by Doppler Ultrasound imaging. About 10% to 15% of infertility cases were found to be SCV.
SCV is one of the common causes of primary infertility and major cause in males with secondary
infertility. Presence of sub-clinical varicocele in case of pediatric patients is considered a risk factor
as it progresses to palpable clinical varicocele. Despite various imaging modalities being tried to
diagnose SCV, color Doppler ultrasound is considered the gold standard imaging for diagnosis
of SCV, having a sensitivity and specificity of nearly 100%. Diagnostic criteria parameters of SCV
includes measurement of diameter of scrotal veins in supine, upright and after valsalva maneuver
along with sum of venous diameter, venous blood flow volume and retrograde flow direction during
valsalva. SCV exerts a significant impact on spermatogenesis. Of all the theories proposed, the
most accepted one is the oxidative stress theory. In many instances, SCV is the only abnormality
associated with oligospermia. Various meta-analyses have shown a significant improvement in
seminal parameters following surgical intervention but pregnancy rate did not improve much when
compared to the non-intervened group. Controversies in surgical management are all centered on
the pregnancy rate. This leaves the treating andrologists and urologists even more confused on how
to go about managing these patients with SCV. The American society of Reproductive Medicine and
American Urological Association do not recommend surgical repair for SCV, if the indication for
varicocelectomy is to improve the pregnancy rate.
Keywords:
Cite the Article:
Muthukumar A, Sekar H, Krishnamoorthy S, Kumaresan N. Subclinical Varicocele (SCV): What the Urologists Need to Know?. World J Surg Surgical Res. 2021; 4: 1281..