A varicocele is an enlargement of veins around the testicle. Many are asymptomatic, while selected patients may have pain, testicular size concerns or fertility-related abnormalities.
Assessment includes history and examination, with ultrasound used when clinically appropriate. In men presenting with infertility, semen analysis and the couple's reproductive context are important.
Microsurgical varicocelectomy may be considered in appropriately selected men. The decision depends on clinical findings, symptoms, semen parameters, testicular status and reproductive goals.
Semen parameters do not improve immediately; follow-up is individualized and recurrence or persistent abnormalities may need reassessment.
Subclinical or asymptomatic varicoceles may not require intervention.
Microsurgical techniques aim to identify and preserve important structures while treating clinically significant veins.
Treatment decisions are individualized after appropriate clinical assessment.
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