Materiały źródłowe

• #1 Varicocele: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/varicocele-7090695

  A varicocele is caused by the failure of valves within the spermatic veins. These valves help regulate the flow of blood through the vein, mostly by preventing the backflow of blood. If the valves are damaged or defective, blood can start to pool, leading to varicocele. […] The cause of a varicocele is unclear, but there are a number of possible explanations: […] Geography of the left testicular vein: The perpendicular position of the left testicular veins causes blood to gush around the 90-degree corner with such force that the valves can begin to fail, causing the veins to gradually enlarge and become twisted (like varicose veins). […] Obstruction of a testicular vein: Right- and left-sided varicoceles can also be caused by blockages in the veins. This may be due to the development of a lesion within the vessel itself or the compression of a vein by nearby organs, such as the intestines. Over time, this can cause the venous valves to become permanently damaged.

• #2 Varicocele | UNC Department of Urology

  https://www.med.unc.edu/urology/patientcare/adult-non-cancer/male-fertility/varicocele/

  Male infertility has been found to be the major cause of a couples inability to conceive. […] A varicocele is an abnormal dilation of varicose veins that drain the testicle, and it can be associated with a progressive decline in testicular sperm and testosterone production. Varicoceles are the most common identifiable cause of male infertility worldwide. […] For infertile men with a prior history of normal fertility (called secondary infertility), a varicocele is a cause in up to 70% of cases. […] Several theories have been proposed to explain the harmful effect of the varicocele on sperm quality. These include the possible effects of pressure, oxygen deprivation, heat injury, or retrograde flow of toxins. […] Regardless of the mechanism, a varicocele is indisputably a significant factor in decreasing testicular function and worsening semen quality in a large percentage of men seen for infertility.

• #3 Varicocele – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771

  A varicocele is enlargement of the veins that transport oxygen-depleted blood away from the testicle. […] A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum. […] The exact cause of a varicocele is unknown. One contributing factor may be the malfunction of valves inside the veins that are intended to keep blood moving in the right direction. Also, the left testicular vein follows a slightly different path than the right vein a path that makes a problem with blood flow more likely on the left. […] When the oxygen-depleted blood gets backed up in the network of veins, they widen (dilate), creating the varicocele.

• #4

  https://www.aurorahealthcare.org/services/urology/varicoceles

  A varicocele is a condition where veins within the pouch of skin that holds the testicles (the scrotum) become swollen. It occurs when the valves within the veins that regulate blood flow in the spermatic cord don’t function correctly, causing blood to pool and the veins to swell. This leads to the formation of a varicose vein, similar to varicose veins that can occur in the legs. […] While the exact cause of varicoceles is unknown, several factors are believed to contribute to varicocele development, including: […] Defective valves: The valves within the testicles are responsible for sending blood toward the heart. When they become weak or malfunction, blood accumulates in the veins, causing swelling and forming a varicocele. […] Genetics: Varicoceles tend to run in families, suggesting a genetic predisposition.

• #5 Varicocele – Wikipedia

  https://en.wikipedia.org/wiki/Varicocele

  A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum; in a woman, it is an abnormal painful swelling to the embryologically identical pampiniform venous plexus; it is more commonly called pelvic compression syndrome. […] There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that testicular valves that are supposed to prevent backflow fail (venous insufficiency) leading to swelling and compression of the valveless pampiniform plexus; the third is due to excessive pressure in upstream veins, created by nutcracker syndrome. […] Theories as to how varicocele affects sperm function include damage via excess heat caused by the blood pooling and oxidative stress on sperm. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 both put men at risk for infertility; these factors may also exacerbate the risk that varicocele will affect fertility.

• #6 Varicocele Causes: Prevention and Treatment – Bimaristan

  https://bi-maristan.com/en/urology/andrology/varicocele-causes/

  Varicocele causes are primarily linked to abnormally enlarged veins within the scrotum, known as the testicular plexus. […] The main cause of varicoceles is a malfunction of the valves within the veins. […] The leading causes of varicocele are usually related to anatomical factors that affect the veins in the scrotum. […] Some of the main causes of primary varicocele include the following: Dysfunctional venous valves: One of the most common causes of varicocele is a malfunction of the one-way valves in the scrotal veins. […] Another important cause of varicoceles is anatomical differences, especially on the left side of the scrotum. […] Hormonal imbalance: Although rare, hormonal imbalances or genetic factors can also contribute to the development of primary varicocele. […] Secondary varicocele causes are usually underlying medical conditions that affect the veins and blood flow in the scrotum.

• #7 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following: […] The angle at which the left testicular vein enters the left renal vein […] The lack of effective antireflux valves at the juncture of the testicular vein and renal vein […] The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect). […] A clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. […] Varicoceles can have detrimental effects on sperm concentration, motility, and morphology, and can reduce sperm DNA integrity and other aspects of sperm function.

• #8 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Varicoceles are thought to develop from a backup of venous blood flow in the internal spermatic vein that causes venous engorgement, which is clinically detectable on scrotal examination. […] Varicoceles are far more common (80% to 90%) in the left testicle. If a left varicocele is identified, there is a 30% to 40% probability it is a bilateral condition. […] There are 3 theories as to the anatomical cause: Failure of the antireflux valve where the internal spermatic vein joins the left renal vein. This failure causes reflux and retrograde flow in the testicular vein. […] Angulation at the juncture of the left internal spermatic vein and the left renal vein. […] The „Nutcracker” effect which occurs when: The left internal spermatic vein gets caught between the superior mesenteric artery and the aorta. This entrapment causes venous compression and spermatic vein obstruction.

• #9 Varicocele: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/varicocele-7090695

  A varicocele is caused by the failure of valves within the spermatic veins. These valves help regulate the flow of blood through the vein, mostly by preventing the backflow of blood. If the valves are damaged or defective, blood can start to pool, leading to varicocele. […] The cause of a varicocele is unclear, but there are a number of possible explanations: […] Geography of the left testicular vein: The perpendicular position of the left testicular veins causes blood to gush around the 90-degree corner with such force that the valves can begin to fail, causing the veins to gradually enlarge and become twisted (like varicose veins). […] Obstruction of a testicular vein: Right- and left-sided varicoceles can also be caused by blockages in the veins. This may be due to the development of a lesion within the vessel itself or the compression of a vein by nearby organs, such as the intestines. Over time, this can cause the venous valves to become permanently damaged.

• #10 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Varicoceles are thought to develop from a backup of venous blood flow in the internal spermatic vein that causes venous engorgement, which is clinically detectable on scrotal examination. […] Varicoceles are far more common (80% to 90%) in the left testicle. If a left varicocele is identified, there is a 30% to 40% probability it is a bilateral condition. […] There are 3 theories as to the anatomical cause: Failure of the antireflux valve where the internal spermatic vein joins the left renal vein. This failure causes reflux and retrograde flow in the testicular vein. […] Angulation at the juncture of the left internal spermatic vein and the left renal vein. […] The „Nutcracker” effect which occurs when: The left internal spermatic vein gets caught between the superior mesenteric artery and the aorta. This entrapment causes venous compression and spermatic vein obstruction.

• #11 Causes & Treament of Varicocele | Georgiadis Urology

  https://www.georgiadis-urology.com/varicocele

  Varicocele means a moderate to high degree of venous plexus distention in the scrotum. In other words, it is an enlargement of the veins in the scrotum. Varicocele is a common cause of reduced sperm production and poor sperm quality. […] The function of the seminal veins is to drain blood from the testes. They achieve this by a mechanism which relies on the good condition of a venous valve system. The movement of these valves transfers blood in contrast to gravity. So, if this system is damaged, blood begins to reflux into the veins causing them to dilate/distend. This establishes the phenomenon of venous failure. […] Intra-abdominal pressure during childhood and adolescence increases in many instances. We consider it as a common predisposing factor for varicocele development. […] In addition, it appears that anatomical factors contribute to varicocele creation. More specifically, the left spermatic vein is straighter than the vein on the right side, ending vertically to the renal vein, and is longer than the opposite one. These cause downward pressure inside the vein which ultimately leads to the condition of the varicocele.

• #12 Varicocele – myDr.com.au

  https://mydr.com.au/mens-health/varicocele/

  A varicocele occurs when the veins that drain the testicle become widened. This is thought to be due to a number of factors, including incompetent (damaged or not functioning) valves in the veins. […] Varicoceles usually occur on the left side because of anatomical differences that increase the pressure in the veins draining the left testicle. These include the increased length of the left spermatic vein (compared with the right) and the angle at which the left-sided vein inserts into the kidney vein. […] These factors, combined with the downward force of gravity, can result in blood pooling in the small veins draining the left testicle, widening them and forming the swelling that is the varicocele.

• #13 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following: […] The angle at which the left testicular vein enters the left renal vein […] The lack of effective antireflux valves at the juncture of the testicular vein and renal vein […] The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect). […] A clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. […] Varicoceles can have detrimental effects on sperm concentration, motility, and morphology, and can reduce sperm DNA integrity and other aspects of sperm function.

• #14 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following: […] The angle at which the left testicular vein enters the left renal vein […] The lack of effective antireflux valves at the juncture of the testicular vein and renal vein […] The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect). […] A clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. […] Varicoceles can have detrimental effects on sperm concentration, motility, and morphology, and can reduce sperm DNA integrity and other aspects of sperm function.

• #15 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Varicoceles are thought to develop from a backup of venous blood flow in the internal spermatic vein that causes venous engorgement, which is clinically detectable on scrotal examination. […] Varicoceles are far more common (80% to 90%) in the left testicle. If a left varicocele is identified, there is a 30% to 40% probability it is a bilateral condition. […] There are 3 theories as to the anatomical cause: Failure of the antireflux valve where the internal spermatic vein joins the left renal vein. This failure causes reflux and retrograde flow in the testicular vein. […] Angulation at the juncture of the left internal spermatic vein and the left renal vein. […] The „Nutcracker” effect which occurs when: The left internal spermatic vein gets caught between the superior mesenteric artery and the aorta. This entrapment causes venous compression and spermatic vein obstruction.

• #16 Varicocele: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/varicocele-7090695

  „Nutcracker syndrome”: This is a condition in which the left renal vein is compressed by the aorta (which services the heart) and the superior mesenteric vein (which services the digestive tract). The compression can further intensify the force of blood to the left testicular veins, leading to valve damage. […] A varicocele is a relatively common condition, affecting 15% to 20% of males and between 30% and 40% of males with infertility. It tends to develop gradually over time. […] Studies have shown that roughly 8% of males between the ages of 11 and 14 and 14% of those between 15 and 19 have varicoceles.

• #17 What is Varicocele, Causes, Symptoms, Diagnosis and Treatment | Prof.Dr. Emin ÖZBEK

  https://dreminozbek.com/en/what-is-varicocele-causes-symptoms-diagnosis-and-treatment/

  Varicocele is one of the important diseases that cause infertility in men. […] The cause of this disease is not fully known. Some theories have been proposed for the cause of varicocele. It is possible to summarize them as follows; The exact cause of varicocele is not known exactly. Mostly seen in puberty (adolescence) […] Insufficiency of the valves in the veins (veins) […] It is often seen on the left side (for anatomical reasons). […] There are no known very specific risk factors for the development of varicocele. Some known risk factors are: It may be a risk factor, as it is common in those who stand for long periods of time. […] It may be genetic (hereditary). It is 3-8 times more common in first-degree relatives with varicocele. […] Varicocele disease does not pose a vital problem, but if left untreated, it can lead to serious problems in the future.

• #18 Varicocele | healthdirect

  https://www.healthdirect.gov.au/varicocele

  A varicocele is generally thought to be caused by a problem with the veins that drain blood from your testicles. Veins contain valves that keep blood flowing towards your heart. If these valves are not working properly, blood can leak backwards and pool in the vein. Eventually, the veins become larger than normal. […] You are more likely to develop a varicocele if it runs in your family, or if you have varicose veins in your legs. […] Rarely, a mass in your abdomen might cause a varicocele to develop.

• #19 Pillar | Medanta

  https://www.medanta.org/pillar/varicocele-types-symptoms-causes-diagnosis-treatment

  Faulty valves: Sometimes, the valves within the testicular veins may be structurally weak or not fully formed. This abnormal structure impairs their ability to regulate blood flow effectively. It can result in blood pooling and vein dilation. […] Increased venous pressure: Factors that increase pressure in the veins can contribute to varicocele formation. These may include physical exertion, prolonged standing or sitting, heavy lifting, and straining during bowel movements. […] Genetic predisposition: According to some studies, genetics is also a causative factor in varicocele development, as it runs in families. Certain genetic factors may contribute to the weakness of the vein walls or valves, making individuals more susceptible to varicocele.

• #20 What Causes Varicocele? – Prof. Dr. Mustafa Sofikerim

  https://mustafasofikerim.com.tr/en/varikosel-neden-olur/

  Insufficiency of the vascular valves can also trigger this condition. The valves work to prevent the backflow of blood. However, when these valves are weak, blood backflow occurs, causing varicocele formation. […] The risk of developing varicocele increases in individuals with a family history. Due to genetic predisposition, some individuals may have a weak vascular structure. This causes the venous structure to not function properly. […] Weak vein walls or inadequate valves contribute to the formation of varicoceles. In these individuals, varicoceles usually become more noticeable during puberty. […] The answer to the question is related to genetic factors.

• #21

  https://www.aurorahealthcare.org/services/urology/varicoceles

  Hormonal changes: Hormonal fluctuations, particularly during puberty, are believed to play a role. Increased hormone activity may lead to dilation of the testicular veins, contributing to varicocele formation. […] Physical activity: Prolonged standing or sitting can put pressure on the veins in the scrotum, causing them to dilate and potentially contributing to varicocele development. […] Although less common, varicoceles can also be caused by external factors like tumors, kidney disease or injuries that disrupt blood flow in the scrotal region.

• #22 Varicocele: Varicose Veins in Testicles – Symptoms, Treatment – Urology | UCLA Health

  https://www.uclahealth.org/medical-services/urology/conditions-treated/male-conditions/varicocele-symptoms-treatment-diagnosis

  Varicoceles are believed to be caused by defective valves in the veins within the scrotum, just above the testicles. […] Normally, these valves regulate the flow of blood to and from the testicles. When normal flow doesn’t occur, the blood backs up, causing the veins to dilate (enlarge). This most commonly takes place during puberty, when the testicles are experiencing rapid growth and need the most blood. In about 85% of cases, it occurs in the left testicle area. The poor circulation caused by the varicocele results in a higher blood temperature, raising the temperature of the testes, which can serve as a barrier to sperm production and damage or destroy sperm that is created.

• #23 Varicocele: Causes, Symptoms, Diagnosis, and Treatment

  https://www.webmd.com/men/what-is-varicocele

  Doctors arent sure what causes this condition. It could be a problem with blood flow in the spermatic cord, which carries blood to and from your testicles. If valves inside the veins in the cord dont work as they should, the blood backs up, and the veins get wider. […] When varicoceles happen in teens, its often because of their quick growth during puberty. The testicles need more blood than normal as they develop, and any kind of problem in the veins can keep the blood from getting where it needs to go.

• #24 Varicocele Causes: Prevention and Treatment – Bimaristan

  https://bi-maristan.com/en/urology/andrology/varicocele-causes/

  Some secondary causes of varicocele include the following: Abdominal tumors: Tumors or growths in the abdominal area can obstruct blood flow, especially those that compress the veins, draining blood from the scrotum. […] Kidney disease or blockage: Conditions such as kidney cancer or renal vein thrombosis can obstruct blood flow to the scrotal veins, leading to secondary varicocele by impeding normal blood drainage. […] Understanding varicoceles different causes, including primary and secondary factors, is critical for accurate diagnosis and effective treatment.

• #25 Varicocele: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001284.htm

  A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly. Blood backs up, leading to swelling and widening of the veins. (This is similar to varicose veins in the legs.) […] A varicocele in an older man that appears suddenly may be caused by a kidney tumor, which can block blood flow to a vein.

• #26 Varicocele Causes: Prevention and Treatment – Bimaristan

  https://bi-maristan.com/en/urology/andrology/varicocele-causes/

  Some secondary causes of varicocele include the following: Abdominal tumors: Tumors or growths in the abdominal area can obstruct blood flow, especially those that compress the veins, draining blood from the scrotum. […] Kidney disease or blockage: Conditions such as kidney cancer or renal vein thrombosis can obstruct blood flow to the scrotal veins, leading to secondary varicocele by impeding normal blood drainage. […] Understanding varicoceles different causes, including primary and secondary factors, is critical for accurate diagnosis and effective treatment.

• #27 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Rare causes of varicoceles include deep vein thrombosis, renal arteriovenous malformations, and thrombosis of the pampiniform plexus. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 increase the risk of male infertility. […] When a varicocele contributes to an abnormal semen analysis, it typically causes a „stress pattern” on microscopic semen examination. This pattern consists of a low sperm count, poor motility, and an increase in the percentage of abnormal sperm.

• #28 Varicocele | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/varicocele-1?lang=us

  Varicocele can be classified as primary or secondary. […] Most varicoceles are primary and result from incompetent or congenitally absent valves in the testicular vein (internal spermatic vein). […] Secondary varicocele is much less common and results from increased pressure in the testicular vein due to compression (e.g. extrinsic mass such as retroperitoneal lymphadenopathy or renal mass, or renal vein compression in nutcracker syndrome), obstruction (e.g. renal vein thrombosis), or splenorenal shunting (portal hypertension).

• #29 Varicocele: Causes, Symptoms, and Diagnosis | HayatMedTour

  https://hayatmedtour.com/Blog/varicocele-causes-symptoms-and-diagnosis/

  Varicocele is one of the most common causes of male infertility. The cause of varicocele is not known definitively, but its complications can lead to decreased sperm production and quality and fertility problems. […] The exact cause of varicocele is not clear. However, many experts believe that the cause of varicocele is a disorder in the valves inside the spermatic veins, which prevents the proper passage of blood. Therefore, the blood collects in the veins and swells and can damage the testicle. […] Another cause of varicocele can be swelling in the lymph nodes behind the abdomen or abnormal masses in the abdomen. […] It is not known exactly why varicocele causes infertility in men. But experts propose different theories for this issue: Accumulation of blood in the testicular vein causes the testicular temperature to rise. An increase in testicular temperature can damage sperm and reduce its quality.

• #30 Bilateral Varicocele: what it is, causes, symptoms and treatment

  https://www.operarme.com/blog/bilateral-varicocele-what-it-is-causes-symptoms-and-treatment/

  Bilateral varicocele is the same as the usual varicocele, inflammation of the venous plexus that nourishes the testicle, with the difference that bilateral varicocele affects both testicles. […] One of the causes of bilateral varicocele in many cases is a retro peritoneal tumour or cirrhosis of the liver, although in others it is something congenital that occurs regularly. […] The appearance of bilateral varicocele, especially right varicocele, is often due to the appearance of a retroperitoneal tumour or cirrhosis of the liver (a degenerative disease of the liver that produces an enlarged liver with an alteration in its normal functioning) that compresses the venous plexus (a group of arteries and veins) responsible for nourishing the testicle. […] On the other hand, in the vast majority of cases, it is a congenital problem that can cause the venous plexus to dilate and accumulate blood throughout life, disrupting normal testicular flow. […] There are also various degrees of varicocele depending on how easy it is to diagnose or how severe it is.

• #31 Varicocele | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/varicocele-1?lang=us

  Varicocele can be classified as primary or secondary. […] Most varicoceles are primary and result from incompetent or congenitally absent valves in the testicular vein (internal spermatic vein). […] Secondary varicocele is much less common and results from increased pressure in the testicular vein due to compression (e.g. extrinsic mass such as retroperitoneal lymphadenopathy or renal mass, or renal vein compression in nutcracker syndrome), obstruction (e.g. renal vein thrombosis), or splenorenal shunting (portal hypertension).

• #32 Varicoceles: Treatment, surgery, and symptoms

  https://www.medicalnewstoday.com/articles/221051

  As with any other organ, a disruption in blood flow can eventually stop it from working properly. […] Varicoceles can be classified as: […] The left testicle is most likely to be affected. However, even if only one side contains a varicocele, this can impact sperm production on both sides. […] There are no particular risk factors known for varicoceles, but they are most likely to appear during puberty. […] It was previously thought that once a man has fathered a child, he is unlikely to be infertile after this, but in 1993, researchers concluded that this was probably untrue. Instead, they suggest that the risk of infertility may increase over time. […] If varicoceles develop in a man aged over 40 years, it is more likely to be due to a blockage in a larger vein in the abdominal area, possibly as a result of a kidney tumor.

• #33 Causes of Varicoceles & Treatment | Testicular Veins azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/what-causes-varicoceles-and-can-i-prevent-them/

  Varicoceles develop when the valves inside the veins stop working properly and fail to direct blood out of the testicles and back towards the heart. Improper blood flow through these veins can cause blood to pool and flow backward into the veins to result in swelling and enlargement. […] An estimated 15 out of 100 men suffer from varicoceles. There are no significant risk factors or other varicocele causes, and no known associations with race, ethnicity, place of birth, or defects. Varicoceles often develop during puberty and are more common in males between the ages of 15 and 25. Varicoceles that suddenly develop in older men may be caused by a kidney tumor, which can interfere with blood flow to veins in the testicles.

• #34 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Several theories have been proposed to explain the harmful effect of varicoceles on sperm quality, including the possible effects of pressure, oxygen deprivation, heat injury, and toxins. […] Despite considerable research, none of the theories has been proved unquestionably, although an elevated heat effect caused by impaired circulation appears to be the most reproducible defect. […] Regardless of the mechanism of action, a varicocele is indisputably a significant factor in decreasing testicular function and in reducing semen quality in a large percentage of men who seek infertility treatment. […] An unproven hypothesis holds that a varicocele may represent a progressive lesion that can have detrimental effects on testicular function. […] An untreated varicocele, especially when large, may cause long-term deterioration in sperm production and even testosterone production.

• #35 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Several theories have been proposed to explain the harmful effect of varicoceles on sperm quality, including the possible effects of pressure, oxygen deprivation, heat injury, and toxins. […] Despite considerable research, none of the theories has been proved unquestionably, although an elevated heat effect caused by impaired circulation appears to be the most reproducible defect. […] Regardless of the mechanism of action, a varicocele is indisputably a significant factor in decreasing testicular function and in reducing semen quality in a large percentage of men who seek infertility treatment. […] An unproven hypothesis holds that a varicocele may represent a progressive lesion that can have detrimental effects on testicular function. […] An untreated varicocele, especially when large, may cause long-term deterioration in sperm production and even testosterone production.

• #36 Varicocele Causes, Symptoms, & Treatment | Varicocele Pain

  https://www.theturekclinic.com/experiencing-pain/

  A varicocele is like a varicose vein in the leg, except that the swollen, twisted vein develops in the scrotum. […] Identifying and treating varicocele can have a tremendously positive effect on male fertility and may help you father the biological children you have always wanted. […] Varicoceles usually begin at puberty. Varicoceles often occur on the left testicle because the left testicular vein anatomy where it empties into the body near the kidney is subjected to the forces of gravity. […] Sometimes, these valves do not close completely or properly, and blood starts to flow backward due to gravity. This forms a varicocele, or enlargement of the veins. […] We believe that excess warm blood in the scrotum comes down from the warmer body above it and causes the testes to overheat, interfering with their ability to make sperm and testosterone. […] If something warms the testicles (like blood coming down from the body and pooling in the veins), it generally impairs sperm production.

• #37 Varicocele: Causes, Symptoms, and Treatment

  https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/varicocele

  A varicocele is a collection of enlarged (dilated) veins (blood vessels) in the scrotum. It occurs next to and above one testicle (testis) or both testes (testicles). […] In most cases, the reason why the veins (blood vessels) become larger is because the valves of the small veins in the scrotum do not function well. […] Very rarely, a varicocele may develop if there is a blockage of larger veins higher in the tummy (abdomen), such as from a tumour in one of the kidneys, or near to it. […] Varicoceles are thought to be one of the most common causes of male infertility. […] We don’t know exactly why varicoceles are linked to infertility. One theory is that the pooled blood causes a slightly higher temperature in the scrotum than normal, even if the varicocele is only present on one side.

• #38 Varicocele-induced infertility: Newer insights into its pathophysiology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114589/

  The association between varicoceles and male infertility has been known since the 1950s; however, the pathophysiology of the process remains uncertain. The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these factors contribute to the infertile phenotype seen in clinical practice. […] Moreover, patient lifestyle and genetic factors likely affect patient susceptibilities to the varicocele insult. […] The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these etiological causes contribute to the infertile phenotype seen in clinical practice. […] Our current understanding of the pathophysiology of the varicocele is built upon both human data as well as animal models.

• #39 Varicocele – Wikipedia

  https://en.wikipedia.org/wiki/Varicocele

  A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum; in a woman, it is an abnormal painful swelling to the embryologically identical pampiniform venous plexus; it is more commonly called pelvic compression syndrome. […] There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that testicular valves that are supposed to prevent backflow fail (venous insufficiency) leading to swelling and compression of the valveless pampiniform plexus; the third is due to excessive pressure in upstream veins, created by nutcracker syndrome. […] Theories as to how varicocele affects sperm function include damage via excess heat caused by the blood pooling and oxidative stress on sperm. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 both put men at risk for infertility; these factors may also exacerbate the risk that varicocele will affect fertility.

• #40 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Rare causes of varicoceles include deep vein thrombosis, renal arteriovenous malformations, and thrombosis of the pampiniform plexus. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 increase the risk of male infertility. […] When a varicocele contributes to an abnormal semen analysis, it typically causes a „stress pattern” on microscopic semen examination. This pattern consists of a low sperm count, poor motility, and an increase in the percentage of abnormal sperm.

• #41 Varicocele – Wikipedia

  https://en.wikipedia.org/wiki/Varicocele

  A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum; in a woman, it is an abnormal painful swelling to the embryologically identical pampiniform venous plexus; it is more commonly called pelvic compression syndrome. […] There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that testicular valves that are supposed to prevent backflow fail (venous insufficiency) leading to swelling and compression of the valveless pampiniform plexus; the third is due to excessive pressure in upstream veins, created by nutcracker syndrome. […] Theories as to how varicocele affects sperm function include damage via excess heat caused by the blood pooling and oxidative stress on sperm. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 both put men at risk for infertility; these factors may also exacerbate the risk that varicocele will affect fertility.

• #42 Varicocele: Causes, Symptoms, and Diagnosis | HayatMedTour

  https://hayatmedtour.com/Blog/varicocele-causes-symptoms-and-diagnosis/

  Poor blood circulation in the testicles can increase toxins in the blood and affect sperm health. […] Increasing the pressure on the testicle can disturb the function of the testicle and cause problems with the production of sperm. […] Weak blood circulation in the testicles disrupts the supply of oxygen to the testicles and prevents the production of healthy sperm.

• #43 Varicocele: Causes, Symptoms, and Diagnosis | HayatMedTour

  https://hayatmedtour.com/Blog/varicocele-causes-symptoms-and-diagnosis/

  Poor blood circulation in the testicles can increase toxins in the blood and affect sperm health. […] Increasing the pressure on the testicle can disturb the function of the testicle and cause problems with the production of sperm. […] Weak blood circulation in the testicles disrupts the supply of oxygen to the testicles and prevents the production of healthy sperm.

• #44 Varicocele: Causes, Symptoms, and Diagnosis | HayatMedTour

  https://hayatmedtour.com/Blog/varicocele-causes-symptoms-and-diagnosis/

  Poor blood circulation in the testicles can increase toxins in the blood and affect sperm health. […] Increasing the pressure on the testicle can disturb the function of the testicle and cause problems with the production of sperm. […] Weak blood circulation in the testicles disrupts the supply of oxygen to the testicles and prevents the production of healthy sperm.

• #45 VARICOCELE

  http://www.drmuradbasar.com/en/pages/infertility/varicocele

  Varicocele is a vascular disease caused by enlargement of the testicular veins (plexus pampiniformis), and seen in 30-45% of infertile male, 45–81% of which with secondary infertility. […] The cause of varicocele is unclear. Tall height, overweight, prolonged standing, increased intra-abdominal pressure (due to chronic constipation, chronic lung disease, chronic cough, heavy sports, etc.) may be risk factors for varicocele formation. […] Varicocele causes a continuous and increasing damage over time on testis. The effects of varicocele on sperm are explained by the following mechanisms: Disrupted oxidative stress control mechanism, Increased scrotal temperature affects sperm production, Back flow of toxic substances from kidney and adrenal gland into the testicle, Decreased testicular blood flow. […] Semen parameters improve in 50-80% of patients after varicocele treatment.

• #46 Varicocele: Causes, Symptoms, and Diagnosis | HayatMedTour

  https://hayatmedtour.com/Blog/varicocele-causes-symptoms-and-diagnosis/

  Poor blood circulation in the testicles can increase toxins in the blood and affect sperm health. […] Increasing the pressure on the testicle can disturb the function of the testicle and cause problems with the production of sperm. […] Weak blood circulation in the testicles disrupts the supply of oxygen to the testicles and prevents the production of healthy sperm.

• #47 The Evolving Landscape of Male Varicocele Pathophysiology in the Era of Multi-Omics: A Narrative Review of the Current Literature

  https://www.mdpi.com/2079-7737/13/2/80

  The pathophysiologic mechanism for varicoceles is complex and next-generation technologies offer promising insights into the molecular underpinnings of this condition. […] The literature currently suggests that varicoceles are associated with heterogeneous Sertoli and Leydig cell dysfunction, reduced numbers of Sertoli or Leydig cells, and upregulation of pro-inflammatory factors. […] The blood–testis barrier (BTB) is one of the tightest blood–tissue barriers in the human body and divides the seminiferous tubule into distinct basal and apical compartments. […] The current AUA guidelines recommend surgical ligation of varicoceles in infertile men with clinical (e.g., palpable) varicoceles and abnormal semen parameters. […] Varicocele pathophysiology and its ensuing male-factor infertility remains a complex disease process with an evolving knowledge base.

• #48 Varicocele – What It Is & Treatment | CCRM Fertility

  https://www.ccrmivf.com/varicocele/

  While the exact cause of varicoceles is unknown, many experts believe a varicocele occurs when the valves inside the veins in the spermatic cord prevent the blood from flowing properly. […] This causes veins to dilate or swell potentially causing temperature changes in the surrounding testicular tissue, which may impact fertility. […] Varicoceles might impact the temperature in or around the testicles, affecting sperm concentration and quality. […] Varicoceles can cause oligospermia, or low sperm count. […] Varicoceles have also been linked to lower testosterone levels.

• #49 Varicocele | UNC Department of Urology

  https://www.med.unc.edu/urology/patientcare/adult-non-cancer/male-fertility/varicocele/

  Male infertility has been found to be the major cause of a couples inability to conceive. […] A varicocele is an abnormal dilation of varicose veins that drain the testicle, and it can be associated with a progressive decline in testicular sperm and testosterone production. Varicoceles are the most common identifiable cause of male infertility worldwide. […] For infertile men with a prior history of normal fertility (called secondary infertility), a varicocele is a cause in up to 70% of cases. […] Several theories have been proposed to explain the harmful effect of the varicocele on sperm quality. These include the possible effects of pressure, oxygen deprivation, heat injury, or retrograde flow of toxins. […] Regardless of the mechanism, a varicocele is indisputably a significant factor in decreasing testicular function and worsening semen quality in a large percentage of men seen for infertility.

• #50 Varicocele: Causes, Symptoms, and Treatment

  https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/varicocele

  The role of varicocele treatment in fertility problems is controversial. […] Currently, the evidence suggests that varicocele treatment probably does improve fertility, but in a selected group of men. […] If a large varicocele develops in a teenager, the testis on the side of the varicocele may not develop as much as would be expected. […] Very rarely, a varicocele can develop rapidly as a symptom of a blockage of a larger vein in the tummy (abdomen) – see above.

• #51 Varicocele Male Infertility: Causes, Symptoms & Treatments

  https://radiology.ucsf.edu/patient-care/sections/ir/advanced-services/varicocele

  A varicocele is a varicose vein of the testicle and scrotum that may cause pain, testicular atrophy (shrinkage) or fertility problems. […] When these valves fail, the blood pools and enlarges the veins around the testicle in the scrotum to cause a varicocele. […] There is an association between varicoceles and infertility. The incidence of varicocele increases to 30 percent in infertile couples. Decreased sperm count, decreased motility of sperm, and an increase in the number of deformed sperm are related to varicoceles. Some experts believe that blocked and enlarged veins around the testes, called varicoceles, cause infertility by raising the temperature in the scrotum and decreasing sperm production. […] Currently there are two treatment options for men with varicoceles: Catheter-directed embolization or surgical ligation. […] Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. […] In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated.

• #52 Varicocele – What It Is & Treatment | CCRM Fertility

  https://www.ccrmivf.com/varicocele/

  While the exact cause of varicoceles is unknown, many experts believe a varicocele occurs when the valves inside the veins in the spermatic cord prevent the blood from flowing properly. […] This causes veins to dilate or swell potentially causing temperature changes in the surrounding testicular tissue, which may impact fertility. […] Varicoceles might impact the temperature in or around the testicles, affecting sperm concentration and quality. […] Varicoceles can cause oligospermia, or low sperm count. […] Varicoceles have also been linked to lower testosterone levels.

• #53 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following: […] The angle at which the left testicular vein enters the left renal vein […] The lack of effective antireflux valves at the juncture of the testicular vein and renal vein […] The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect). […] A clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. […] Varicoceles can have detrimental effects on sperm concentration, motility, and morphology, and can reduce sperm DNA integrity and other aspects of sperm function.

• #54 Varicoceles in Children

  https://www.nationwidechildrens.org/conditions/health-library/varicoceles-in-children

  A varicocele is when veins in the scrotum have become large and swollen (dilated). […] The veins in the scrotum may have valve problems or missing valves. […] Other problems in groin anatomy may also increase the pressure inside the veins and cause swelling. […] If untreated, a varicocele may affect the ability to have children (fertility) later. It can affect the ability of sperm to swim to an egg (reduced sperm motility). […] Treatment is needed if the testicle has become much smaller or your child has a lot of pain. Treatment may include surgery or another method to take out or block the vein with the varicocele. […] If not treated, it may affect the ability to have children (fertility) later.

• #55 Varicocele Male Infertility: Causes, Symptoms & Treatments

  https://radiology.ucsf.edu/patient-care/sections/ir/advanced-services/varicocele

  A varicocele is a varicose vein of the testicle and scrotum that may cause pain, testicular atrophy (shrinkage) or fertility problems. […] When these valves fail, the blood pools and enlarges the veins around the testicle in the scrotum to cause a varicocele. […] There is an association between varicoceles and infertility. The incidence of varicocele increases to 30 percent in infertile couples. Decreased sperm count, decreased motility of sperm, and an increase in the number of deformed sperm are related to varicoceles. Some experts believe that blocked and enlarged veins around the testes, called varicoceles, cause infertility by raising the temperature in the scrotum and decreasing sperm production. […] Currently there are two treatment options for men with varicoceles: Catheter-directed embolization or surgical ligation. […] Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. […] In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated.

• #56 The Top 9 Symptoms of a Varicocele | Azura Vascular Care azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/symptoms-of-a-varicocele/

  Varicoceles are usually the result of incompetent or faulty valves in the veins in your scrotum. […] It’s thought that the enlarged veins that make up a varicocele keep the temperature in or around your testicles higher than normal. […] Doctors believe this may affect sperm production, motility (movement) and function, leading to the potential for lower fertility or male factor infertility. […] In fact, varicoceles are a leading cause of problems in four out of 10 men experiencing infertility issues. […] Doctors also know that varicoceles can interfere with the actual production of testosterone.

• #57 Varicocele: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/varicocele

  A varicocele is an enlargement of the veins within the scrotum. These veins are called the pampiniform plexus. […] A varicocele can result in decreased sperm production and quality, which in some cases can lead to infertility. […] There are no established risk factors for developing a varicocele, and the exact cause is unclear. […] This condition can affect fertility. Varicocele is present in 35 to 44 percent of men with primary infertility and 45 to 81 percent of men with secondary infertility. […] Infertility is a common complication of a varicocele.

• #58 Varicocele | UNC Department of Urology

  https://www.med.unc.edu/urology/patientcare/adult-non-cancer/male-fertility/varicocele/

  Male infertility has been found to be the major cause of a couples inability to conceive. […] A varicocele is an abnormal dilation of varicose veins that drain the testicle, and it can be associated with a progressive decline in testicular sperm and testosterone production. Varicoceles are the most common identifiable cause of male infertility worldwide. […] For infertile men with a prior history of normal fertility (called secondary infertility), a varicocele is a cause in up to 70% of cases. […] Several theories have been proposed to explain the harmful effect of the varicocele on sperm quality. These include the possible effects of pressure, oxygen deprivation, heat injury, or retrograde flow of toxins. […] Regardless of the mechanism, a varicocele is indisputably a significant factor in decreasing testicular function and worsening semen quality in a large percentage of men seen for infertility.

• #59 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Several theories have been proposed to explain the harmful effect of varicoceles on sperm quality, including the possible effects of pressure, oxygen deprivation, heat injury, and toxins. […] Despite considerable research, none of the theories has been proved unquestionably, although an elevated heat effect caused by impaired circulation appears to be the most reproducible defect. […] Regardless of the mechanism of action, a varicocele is indisputably a significant factor in decreasing testicular function and in reducing semen quality in a large percentage of men who seek infertility treatment. […] An unproven hypothesis holds that a varicocele may represent a progressive lesion that can have detrimental effects on testicular function. […] An untreated varicocele, especially when large, may cause long-term deterioration in sperm production and even testosterone production.

• #60 Varicocele | UNC Department of Urology

  https://www.med.unc.edu/urology/patientcare/adult-non-cancer/male-fertility/varicocele/

  In addition, varicoceles may be a cause of progressive damage to the testes, resulting in further atrophy and impairment of seminal parameters. […] Although the mechanisms whereby varicoceles cause impairment in sperm production and semen quality remain theoretical, the statistical association between varicocele and male infertility is unquestionable. […] Furthermore, improvement in semen quality after varicocele correction has been repeatedly demonstrated. […] The resultant improvement in semen quality occurs in close to 70% of patients, and the pregnancy rate is as high as 40%. […] The scrotal varicocele remains the most correctable factor when treating poor semen quality. Therefore, when present in the infertile male who demonstrates abnormalities of semen quality, surgical correction should be strongly considered.

• #61 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Several theories have been proposed to explain the harmful effect of varicoceles on sperm quality, including the possible effects of pressure, oxygen deprivation, heat injury, and toxins. […] Despite considerable research, none of the theories has been proved unquestionably, although an elevated heat effect caused by impaired circulation appears to be the most reproducible defect. […] Regardless of the mechanism of action, a varicocele is indisputably a significant factor in decreasing testicular function and in reducing semen quality in a large percentage of men who seek infertility treatment. […] An unproven hypothesis holds that a varicocele may represent a progressive lesion that can have detrimental effects on testicular function. […] An untreated varicocele, especially when large, may cause long-term deterioration in sperm production and even testosterone production.

• #62 Varicocele | UNC Department of Urology

  https://www.med.unc.edu/urology/patientcare/adult-non-cancer/male-fertility/varicocele/

  In addition, varicoceles may be a cause of progressive damage to the testes, resulting in further atrophy and impairment of seminal parameters. […] Although the mechanisms whereby varicoceles cause impairment in sperm production and semen quality remain theoretical, the statistical association between varicocele and male infertility is unquestionable. […] Furthermore, improvement in semen quality after varicocele correction has been repeatedly demonstrated. […] The resultant improvement in semen quality occurs in close to 70% of patients, and the pregnancy rate is as high as 40%. […] The scrotal varicocele remains the most correctable factor when treating poor semen quality. Therefore, when present in the infertile male who demonstrates abnormalities of semen quality, surgical correction should be strongly considered.

• #63 Varicocele Male Infertility: Causes, Symptoms & Treatments

  https://radiology.ucsf.edu/patient-care/sections/ir/advanced-services/varicocele

  A varicocele is a varicose vein of the testicle and scrotum that may cause pain, testicular atrophy (shrinkage) or fertility problems. […] When these valves fail, the blood pools and enlarges the veins around the testicle in the scrotum to cause a varicocele. […] There is an association between varicoceles and infertility. The incidence of varicocele increases to 30 percent in infertile couples. Decreased sperm count, decreased motility of sperm, and an increase in the number of deformed sperm are related to varicoceles. Some experts believe that blocked and enlarged veins around the testes, called varicoceles, cause infertility by raising the temperature in the scrotum and decreasing sperm production. […] Currently there are two treatment options for men with varicoceles: Catheter-directed embolization or surgical ligation. […] Embolization is equally effective in improving male infertility and costs about the same as surgical ligation. […] In another study, sperm concentration improved in 83 percent of patients undergoing embolization compared to 63 percent of those surgically ligated.

• #64 Varicocele: what it is, causes, symptoms and treatments

  https://www.operarme.com/blog/varicocele-what-it-is-causes-symptoms-and-treatments/

  Varicocele is a progressive pathology, so the expansive process of varicose veins or vascular nodules can be classified into various levels of severity. […] Many agents may be involved in the development of varicocele, which is why it is considered a multifactorial pathology. Even so, the most common causes are: Greater pressure on the left side of the scrotum: The vascularisation in the testicular area is exerting greater pressure on the left side, as the testicular vein has a greater route to flow into the left renal vein, while the right vein flows into the inferior vena cava, much closer and with a significantly lower pressure. […] Age: During puberty there is a considerable increase in blood flow, which can lead to dilation of the veins in the testicles, resulting in varicocele. This pathology usually occurs in young men between the ages of 15 and 25.

• #65 Causes of Varicoceles & Treatment | Testicular Veins azura-logo-white

  https://www.azuravascularcare.com/infovaricocele/what-causes-varicoceles-and-can-i-prevent-them/

  Varicoceles develop when the valves inside the veins stop working properly and fail to direct blood out of the testicles and back towards the heart. Improper blood flow through these veins can cause blood to pool and flow backward into the veins to result in swelling and enlargement. […] An estimated 15 out of 100 men suffer from varicoceles. There are no significant risk factors or other varicocele causes, and no known associations with race, ethnicity, place of birth, or defects. Varicoceles often develop during puberty and are more common in males between the ages of 15 and 25. Varicoceles that suddenly develop in older men may be caused by a kidney tumor, which can interfere with blood flow to veins in the testicles.

• #66 Varicocele – Wikipedia

  https://en.wikipedia.org/wiki/Varicocele

  A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum; in a woman, it is an abnormal painful swelling to the embryologically identical pampiniform venous plexus; it is more commonly called pelvic compression syndrome. […] There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that testicular valves that are supposed to prevent backflow fail (venous insufficiency) leading to swelling and compression of the valveless pampiniform plexus; the third is due to excessive pressure in upstream veins, created by nutcracker syndrome. […] Theories as to how varicocele affects sperm function include damage via excess heat caused by the blood pooling and oxidative stress on sperm. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 both put men at risk for infertility; these factors may also exacerbate the risk that varicocele will affect fertility.

• #67 The Evolving Landscape of Male Varicocele Pathophysiology in the Era of Multi-Omics: A Narrative Review of the Current Literature

  https://www.mdpi.com/2079-7737/13/2/80

  Male-factor infertility is implicated in over half of the millions of cases of infertility worldwide, and varicoceles are the most common correctable cause of male-factor infertility. […] While prior studies have identified numerous anatomic, genetic, and molecular contributors to varicoceles, the true factors underlying the development of male varicoceles remain largely unknown. […] The etiology of varicoceles remains complex and further work will be necessary to better define the interplay between these anatomic, environmental, and biological factors. […] Genetics also appear to play a strong role, with an increased varicocele prevalence in men with close relatives also having the condition. […] The mechanisms impairing testicular and cellular function have been thoroughly studied but remain controversial.

• #68 What Causes Varicocele? – Prof. Dr. Mustafa Sofikerim

  https://mustafasofikerim.com.tr/en/varikosel-neden-olur/

  Insufficiency of the vascular valves can also trigger this condition. The valves work to prevent the backflow of blood. However, when these valves are weak, blood backflow occurs, causing varicocele formation. […] The risk of developing varicocele increases in individuals with a family history. Due to genetic predisposition, some individuals may have a weak vascular structure. This causes the venous structure to not function properly. […] Weak vein walls or inadequate valves contribute to the formation of varicoceles. In these individuals, varicoceles usually become more noticeable during puberty. […] The answer to the question is related to genetic factors.

• #69 Varicocele – Wikipedia

  https://en.wikipedia.org/wiki/Varicocele

  A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum; in a woman, it is an abnormal painful swelling to the embryologically identical pampiniform venous plexus; it is more commonly called pelvic compression syndrome. […] There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connects to the larger outflowing vein at a right angle, which tends to fail; the second is that testicular valves that are supposed to prevent backflow fail (venous insufficiency) leading to swelling and compression of the valveless pampiniform plexus; the third is due to excessive pressure in upstream veins, created by nutcracker syndrome. […] Theories as to how varicocele affects sperm function include damage via excess heat caused by the blood pooling and oxidative stress on sperm. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 both put men at risk for infertility; these factors may also exacerbate the risk that varicocele will affect fertility.

• #70

  https://www.aurorahealthcare.org/services/urology/varicoceles

  Hormonal changes: Hormonal fluctuations, particularly during puberty, are believed to play a role. Increased hormone activity may lead to dilation of the testicular veins, contributing to varicocele formation. […] Physical activity: Prolonged standing or sitting can put pressure on the veins in the scrotum, causing them to dilate and potentially contributing to varicocele development. […] Although less common, varicoceles can also be caused by external factors like tumors, kidney disease or injuries that disrupt blood flow in the scrotal region.

• #71 Varicocele: what it is, causes, symptoms and treatments

  https://www.operarme.com/blog/varicocele-what-it-is-causes-symptoms-and-treatments/

  Hereditary factor: When there are cases of this disease in the family, any man is likely to develop it during his lifetime. […] Prolonged standing: As with varicose veins in the legs, prolonged standing causes the blood vessels in the testicles to overexert themselves to counteract the force of gravity and thus maintain proper circulation.

• #72 Varicoceles and Male Infertility: Causes, Symptoms, and Treatment

  https://www.onefertilitykitchenerwaterloo.com/varicoceles-male-infertility-causes-symptoms-treatment/

  Varicocele causes can be as complex as the investigation into ones infertility. […] In the case of varicoceles, studies have suggested that valve failure may be related due to the use of tobacco products as there is a higher risk of blood vessel damage in smokers. […] That being said, to date, there has not been a case study determining the exact cause of why these blood vessel valves may fail and produce a varicocele. […] The presence of a varicocele prevents the cooling of the blood, prohibiting the production of sperm as the testicle blood cannot be hot for the making of healthy sperm. […] A varicocele not only damages otherwise healthy sperm, but it can also reduce sperm count. […] Through testing, varicoceles have been shown to increase the presence of deformed sperm and inhibit the movement of the possible viable sperm.

• #73 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Rare causes of varicoceles include deep vein thrombosis, renal arteriovenous malformations, and thrombosis of the pampiniform plexus. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 increase the risk of male infertility. […] When a varicocele contributes to an abnormal semen analysis, it typically causes a „stress pattern” on microscopic semen examination. This pattern consists of a low sperm count, poor motility, and an increase in the percentage of abnormal sperm.

• #74 Reddit – The heart of the internet

  https://www.reddit.com/r/varicocele/comments/sf3be7/what_do_you_think_caused_your_varicocele/

  So we already know that varicoceles are caused by defective valves in the veins. However, what could have caused these veins to suddenly stop working properly? What is your theory on how yours came about? […] Heres a list of what Ive seen mentioned by people in this sub. Heavy Lifting […] Poor lifestyle and eating habits […] Overly masturbating??? […] Direct injury to the testicles […] Sitting around all day barely being active […] Etc.

• #75 Pillar | Medanta

  https://www.medanta.org/pillar/varicocele-types-symptoms-causes-diagnosis-treatment

  Faulty valves: Sometimes, the valves within the testicular veins may be structurally weak or not fully formed. This abnormal structure impairs their ability to regulate blood flow effectively. It can result in blood pooling and vein dilation. […] Increased venous pressure: Factors that increase pressure in the veins can contribute to varicocele formation. These may include physical exertion, prolonged standing or sitting, heavy lifting, and straining during bowel movements. […] Genetic predisposition: According to some studies, genetics is also a causative factor in varicocele development, as it runs in families. Certain genetic factors may contribute to the weakness of the vein walls or valves, making individuals more susceptible to varicocele.

• #76 Reddit – The heart of the internet

  https://www.reddit.com/r/varicocele/comments/sf3be7/what_do_you_think_caused_your_varicocele/

  So we already know that varicoceles are caused by defective valves in the veins. However, what could have caused these veins to suddenly stop working properly? What is your theory on how yours came about? […] Heres a list of what Ive seen mentioned by people in this sub. Heavy Lifting […] Poor lifestyle and eating habits […] Overly masturbating??? […] Direct injury to the testicles […] Sitting around all day barely being active […] Etc.

• #77 Reddit – The heart of the internet

  https://www.reddit.com/r/varicocele/comments/qdavmm/what_causes_varicocele/

  Genetics lets say, cant count it out. […] I think heat is what caused mine. […] Maybe its not taking care of our balls. […] I also read that kids that swim dont get it (V)-cooling and gravity change. […] Sedentary lifestyle?

• #78 Varicocele: Symptoms, causes & treatments | Healthy Male

  https://healthymale.org.au/mens-health/varicocele

  Varicoceles are caused by a backup of blood in the veins within the scrotum. […] There are some differences in anatomy between the right and left sides of the body that make varicocele more common on the left. […] Varicoceles are more likely to occur in men with varicose veins in their legs, or those whose fathers or brothers have a varicocele.

• #79 Varicocele | healthdirect

  https://www.healthdirect.gov.au/varicocele

  A varicocele is generally thought to be caused by a problem with the veins that drain blood from your testicles. Veins contain valves that keep blood flowing towards your heart. If these valves are not working properly, blood can leak backwards and pool in the vein. Eventually, the veins become larger than normal. […] You are more likely to develop a varicocele if it runs in your family, or if you have varicose veins in your legs. […] Rarely, a mass in your abdomen might cause a varicocele to develop.

• #80 VARICOCELE

  http://www.drmuradbasar.com/en/pages/infertility/varicocele

  Varicocele is a vascular disease caused by enlargement of the testicular veins (plexus pampiniformis), and seen in 30-45% of infertile male, 45–81% of which with secondary infertility. […] The cause of varicocele is unclear. Tall height, overweight, prolonged standing, increased intra-abdominal pressure (due to chronic constipation, chronic lung disease, chronic cough, heavy sports, etc.) may be risk factors for varicocele formation. […] Varicocele causes a continuous and increasing damage over time on testis. The effects of varicocele on sperm are explained by the following mechanisms: Disrupted oxidative stress control mechanism, Increased scrotal temperature affects sperm production, Back flow of toxic substances from kidney and adrenal gland into the testicle, Decreased testicular blood flow. […] Semen parameters improve in 50-80% of patients after varicocele treatment.

• #81 Varicocele | Pioneer Valley Urology | | Springfield, MA | Palmer, MA | Enfield,

  https://www.pvurology.org/varicocele.php

  Varicoceles most often develop in puberty. The exact reason they develop is unknown, though there is some evidence that obesity may increase a patient’s risk. […] The reason varicoceles most often occur on the left testicle is because of the way the vein is positioned there.

• #82 Varicocele Causes: Prevention and Treatment – Bimaristan

  https://bi-maristan.com/en/urology/andrology/varicocele-causes/

  Varicocele causes are primarily linked to abnormally enlarged veins within the scrotum, known as the testicular plexus. […] The main cause of varicoceles is a malfunction of the valves within the veins. […] The leading causes of varicocele are usually related to anatomical factors that affect the veins in the scrotum. […] Some of the main causes of primary varicocele include the following: Dysfunctional venous valves: One of the most common causes of varicocele is a malfunction of the one-way valves in the scrotal veins. […] Another important cause of varicoceles is anatomical differences, especially on the left side of the scrotum. […] Hormonal imbalance: Although rare, hormonal imbalances or genetic factors can also contribute to the development of primary varicocele. […] Secondary varicocele causes are usually underlying medical conditions that affect the veins and blood flow in the scrotum.

• #83 Varicocele | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/varicocele-1?lang=us

  Varicocele can be classified as primary or secondary. […] Most varicoceles are primary and result from incompetent or congenitally absent valves in the testicular vein (internal spermatic vein). […] Secondary varicocele is much less common and results from increased pressure in the testicular vein due to compression (e.g. extrinsic mass such as retroperitoneal lymphadenopathy or renal mass, or renal vein compression in nutcracker syndrome), obstruction (e.g. renal vein thrombosis), or splenorenal shunting (portal hypertension).

• #84 Varicocele: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001284.htm

  A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly. Blood backs up, leading to swelling and widening of the veins. (This is similar to varicose veins in the legs.) […] A varicocele in an older man that appears suddenly may be caused by a kidney tumor, which can block blood flow to a vein.

• #85 Varicoceles: Treatment, surgery, and symptoms

  https://www.medicalnewstoday.com/articles/221051

  As with any other organ, a disruption in blood flow can eventually stop it from working properly. […] Varicoceles can be classified as: […] The left testicle is most likely to be affected. However, even if only one side contains a varicocele, this can impact sperm production on both sides. […] There are no particular risk factors known for varicoceles, but they are most likely to appear during puberty. […] It was previously thought that once a man has fathered a child, he is unlikely to be infertile after this, but in 1993, researchers concluded that this was probably untrue. Instead, they suggest that the risk of infertility may increase over time. […] If varicoceles develop in a man aged over 40 years, it is more likely to be due to a blockage in a larger vein in the abdominal area, possibly as a result of a kidney tumor.

• #86 Varicocele | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/varicocele-1?lang=us

  Varicocele can be classified as primary or secondary. […] Most varicoceles are primary and result from incompetent or congenitally absent valves in the testicular vein (internal spermatic vein). […] Secondary varicocele is much less common and results from increased pressure in the testicular vein due to compression (e.g. extrinsic mass such as retroperitoneal lymphadenopathy or renal mass, or renal vein compression in nutcracker syndrome), obstruction (e.g. renal vein thrombosis), or splenorenal shunting (portal hypertension).

• #87

  https://www.aurorahealthcare.org/services/urology/varicoceles

  Hormonal changes: Hormonal fluctuations, particularly during puberty, are believed to play a role. Increased hormone activity may lead to dilation of the testicular veins, contributing to varicocele formation. […] Physical activity: Prolonged standing or sitting can put pressure on the veins in the scrotum, causing them to dilate and potentially contributing to varicocele development. […] Although less common, varicoceles can also be caused by external factors like tumors, kidney disease or injuries that disrupt blood flow in the scrotal region.

• #88 Varicocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448113/

  Rare causes of varicoceles include deep vein thrombosis, renal arteriovenous malformations, and thrombosis of the pampiniform plexus. […] Tobacco smoking and mutations in the gene expressing glutathione S-transferase Mu 1 increase the risk of male infertility. […] When a varicocele contributes to an abnormal semen analysis, it typically causes a „stress pattern” on microscopic semen examination. This pattern consists of a low sperm count, poor motility, and an increase in the percentage of abnormal sperm.

• #89 :: YMJ :: Yonsei Medical Journal

  https://eymj.org/DOIx.php?id=10.3349/ymj.2012.53.4.723

  The pathophysiology of varicocele has been attributed to one of three primary factors: increased venous pressure in the left renal vein or gonadal vein, reflux in the collateral veins, and incompetent ISV valves. The processes underlying recurrence appear to be similar. […] The most common cause of persistent or recurrent varicocele after surgical repair involves the ISVs. Redundancies of the gonadal veins confined to the region in or near the inguinal canal appear to be responsible for the majority of post-surgical persistent or recurrent varicocele. […] The second most important factor influencing varicocele recurrence is collateral venous anastomosis. […] The present study may support the significant role of extrafunicular veins in varicocele recurrence. We think that the persistent ISVs and collateral veins of ISV are the causes of varicocele recurrence.

• #90 Varicocele: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438591-overview

  Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following: […] The angle at which the left testicular vein enters the left renal vein […] The lack of effective antireflux valves at the juncture of the testicular vein and renal vein […] The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect). […] A clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. […] Varicoceles can have detrimental effects on sperm concentration, motility, and morphology, and can reduce sperm DNA integrity and other aspects of sperm function.

• #91 Varicocele: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/varicocele-7090695

  „Nutcracker syndrome”: This is a condition in which the left renal vein is compressed by the aorta (which services the heart) and the superior mesenteric vein (which services the digestive tract). The compression can further intensify the force of blood to the left testicular veins, leading to valve damage. […] A varicocele is a relatively common condition, affecting 15% to 20% of males and between 30% and 40% of males with infertility. It tends to develop gradually over time. […] Studies have shown that roughly 8% of males between the ages of 11 and 14 and 14% of those between 15 and 19 have varicoceles.

• #92 Sneeze and pop: a ruptured varicocele; analysis of literature, guided by a well-documented case-report | BMC Urology | Full Text

  https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0442-z

  A varicocele is present in about 15% of healthy males. A spontaneous rupture of a varicocele, resulting in an acute scrotal hematoma however, is a rare phenomenon. Sudden increase in abdominal pressure, resulting to an increased venous pressure can lead to a rupture of the varicocele. […] Idiopathic, spontaneous hematomas are thought to be the result of sudden increase of abdominal pressure transmitting to a varicocele. Its arbitrary whether abdominal trauma can lead to increased abdominal pressure, resulting in a ruptured varicocele. A study of Shafik Bedeir (1980) showed that patients with a left-sided varicocele develop an increased venous pressure during a Valsalva manoeuvre. Various structures, (i.e. vein of the normal pampiniform plexus, a single varix or false aneurysm of the spermatic artery), have been identified as bleeding source. However, in the majority of cases the bleeding source at surgery cannot be identified.

• #93 Varicocele-induced infertility: Newer insights into its pathophysiology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114589/

  The association between varicoceles and male infertility has been known since the 1950s; however, the pathophysiology of the process remains uncertain. The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these factors contribute to the infertile phenotype seen in clinical practice. […] Moreover, patient lifestyle and genetic factors likely affect patient susceptibilities to the varicocele insult. […] The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these etiological causes contribute to the infertile phenotype seen in clinical practice. […] Our current understanding of the pathophysiology of the varicocele is built upon both human data as well as animal models.

• #94 The Evolving Landscape of Male Varicocele Pathophysiology in the Era of Multi-Omics: A Narrative Review of the Current Literature

  https://www.mdpi.com/2079-7737/13/2/80

  Male-factor infertility is implicated in over half of the millions of cases of infertility worldwide, and varicoceles are the most common correctable cause of male-factor infertility. […] While prior studies have identified numerous anatomic, genetic, and molecular contributors to varicoceles, the true factors underlying the development of male varicoceles remain largely unknown. […] The etiology of varicoceles remains complex and further work will be necessary to better define the interplay between these anatomic, environmental, and biological factors. […] Genetics also appear to play a strong role, with an increased varicocele prevalence in men with close relatives also having the condition. […] The mechanisms impairing testicular and cellular function have been thoroughly studied but remain controversial.

• #95 Varicocele-induced infertility: Newer insights into its pathophysiology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3114589/

  The association between varicoceles and male infertility has been known since the 1950s; however, the pathophysiology of the process remains uncertain. The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these factors contribute to the infertile phenotype seen in clinical practice. […] Moreover, patient lifestyle and genetic factors likely affect patient susceptibilities to the varicocele insult. […] The primary proposed hypotheses involve hyperthermia, venous pressure, testicular blood flow, hormonal imbalance, toxic substances, and reactive oxygen species. […] It is difficult to identify a single or dominant factor, and it is likely that many of these etiological causes contribute to the infertile phenotype seen in clinical practice. […] Our current understanding of the pathophysiology of the varicocele is built upon both human data as well as animal models.

• #96 The Evolving Landscape of Male Varicocele Pathophysiology in the Era of Multi-Omics: A Narrative Review of the Current Literature

  https://www.mdpi.com/2079-7737/13/2/80

  The pathophysiologic mechanism for varicoceles is complex and next-generation technologies offer promising insights into the molecular underpinnings of this condition. […] The literature currently suggests that varicoceles are associated with heterogeneous Sertoli and Leydig cell dysfunction, reduced numbers of Sertoli or Leydig cells, and upregulation of pro-inflammatory factors. […] The blood–testis barrier (BTB) is one of the tightest blood–tissue barriers in the human body and divides the seminiferous tubule into distinct basal and apical compartments. […] The current AUA guidelines recommend surgical ligation of varicoceles in infertile men with clinical (e.g., palpable) varicoceles and abnormal semen parameters. […] Varicocele pathophysiology and its ensuing male-factor infertility remains a complex disease process with an evolving knowledge base.

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