Endovascular Treatment of Male Varicocele

V aricocele is defined as the dilatation of the veins of the pampiniform plexus. It is a wellknown clinical entity that may result in masseffect, pain, testicular atrophy, and infertility. It is estimated to be present in 40% of males with fertility issues1 and in up to 16% of male adolescents.2 The pathophysiology of varicocele is related to venous insufficiency and reflux involving the veins that drain the testis. The left internal spermatic vein (ISV) is involved more often than the right, and a bilateral presentation is seen in up to 10% of clinical varicoceles.3 Although varicocele may be first noticed as a palpable abnormality, the more important pathology associated with varicocele is that it is a known etiology for abnormal spermatic parameters leading to infertility. Fortunately, there are numerous treatment options, including endovascular, open, and laparoscopic surgical approaches.