Varicocelectomy: twenty-five years of experience.

The effectiveness of varicocelectomy in the therapy of male infertility has been well documented. We favor a modification of the Ivanissevich procedure. It is simple and can be done well by the average surgeon, and results have been excellent. Surgery is indicated by poor sperm motility and immaturity. The presence of a varicocele with the absence of this combination of semen defects would not be sufficient indication for surgery. The actual effects of varicocele on fertility are still unknown, for many men with varicocele have normal semen qualities and adequate fertility. The study of our varicocelectomy failures does not reveal any preoperative differences between them and those that show improvement after surgery.