Franco Antonio, Proietti Flavia, Palombi Veronica, Savarese Gabriele, Guidotti Michele, Leonardo Costantino, Ferro Fabio, Manna Claudio, Franco Giorgio
Department of Urology, Sant'Andrea Hospital, "Sapienza" University of Rome, 00185 Rome, Italy.
Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, 00185 Rome, Italy.
J Clin Med. 2023 Jun 15;12(12):4062. doi: 10.3390/jcm12124062.
Varicocele treatment in infertility still remains controversial. It is clear, in fact, that in many patients, varicocele has no impact on fertility. Recent scientific evidence demonstrated that varicocele treatment is beneficial in improving semen parameters and pregnancy rate when an appropriate selection of patients is made. The purpose of treating varicocele in adults is mainly to improve current fertility status. On the other hand, the goal of treatment in adolescents is to prevent testicular injury and maintain testicular function for future fertility. Hence, the key to the success of varicocele treatment seems to be a correct indication. The aim of this study is to review and summarize current evidence in managing varicocele treatment focusing on the controversies regarding surgical indications in adolescent and adult patients, and in other specific situations such as azoospermia, bilateral or subclinical varicocele, and prior to ART.
精索静脉曲张在不育症治疗中仍然存在争议。事实上，很明显，在许多患者中，精索静脉曲张对生育能力没有影响。最近的科学证据表明，在进行适当的患者选择时，精索静脉曲张治疗有助于改善精液参数和提高妊娠率。治疗成人精索静脉曲张的主要目的是改善当前的生育状况。另一方面，青少年治疗的目标是预防睾丸损伤并维持睾丸功能以保障未来的生育能力。因此，精索静脉曲张治疗成功的关键似乎在于正确的适应症。本研究的目的是回顾和总结当前精索静脉曲张治疗管理方面的证据，重点关注青少年和成年患者手术适应症的争议，以及其他特定情况，如无精子症、双侧或亚临床精索静脉曲张以及辅助生殖技术之前的情况。
