Impact of microscopic intermediate sub inguinal varicocelectomy on varicocele and infertility

Varicocele is primarily tortuous dilation of the internal spermatic vein [ISV] and pampiniform plexus in scrotum. It’s most common correctable cause infertility. It has a higher prevalence primary secondary infertility men. In this article, we reviewed advantages disadvantages microscopic intermediate sub inguinal [MISV] varicocelectomies over conventional surgical methods. Although various mechanisms are postulated for pathogenesis, increased venous reflux accepted as predominant cause. Varicocelectomy done to ligate veins reduce without affecting arteries, vas deferens lymphatics. Open, laparoscopic different approaches varicocele. Embolization another treatment option. MISV relatively novel technique considered superior because spontaneous pregnancy rates, reduced recurrence, seminal parameters fewer postoperative complications, evidenced by many studies. Microscopic visualization usage micro-doppler surgery gives more safe easy handling operative field. Absolute indications varicocelectomy documented infertility, clinically palpable varicocele abnormal potentially treatable female or normal fertility. Persistent pain, discrepancies testicular volume than 20% hypogonadism relative varicocelectomies. should be regarded gold standard method