Varikosel ve Erkek İnfertilitesi; Tanı, Endikasyon ve Tedavi Sonuçları

Yazarlar

Cem Tuğrul Gezmiş
https://orcid.org/0000-0002-1634-4516

Referanslar

European Association of Urology. EAU Guidelines on Sexual and Reproductive Health 2025. Arnhem, The Netherlands: EAU Guidelines Office; 2025.

World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 6th ed. Geneva: World Health Organization; 2021.

Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline Part I. The Journal of Urology. 2021;205(1):36–43. doi:10.1097/JU.0000000000001521.

Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertility and Sterility. 1993;59(3):613–616. doi:10.1016/S0015-0282(16)55809-9.

Naughton CK, Nangia AK, Agarwal A. Varicocele and male infertility: Part II: Pathophysiology of varicoceles in male infertility. Human Reproduction Update. 2001;7(5):473–481. doi:10.1093/humupd/7.5.473.

Agarwal A, Hamada A, Esteves SC. Insight into oxidative stress in varicocele-associated male infertility: Part 1. Nature Reviews Urology. 2012;9(12):678–690. doi:10.1038/nrurol.2012.197.

Baazeem A, Belzile E, Ciampi A, et al. Varicocele and male factor infertility treatment: A new meta-analysis and review of the role of varicocele repair. European Urology. 2011;60(4):796–808. doi:10.1016/j.eururo.2011.06.018.

Jensen CFS, Østergren P, Dupree JM, et al. Varicocele and male infertility. Nature Reviews Urology. 2017;14(9):523–533. doi:10.1038/nrurol.2017.98.

Damsgaard J, Joensen UN, Carlsen E, et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: A study of 7035 healthy young men from six European countries. European Urology. 2016;70(6):1019–1029. doi:10.1016/j.eururo.2016.06.044.

Pallotti F, Paoli D, Carlini T, et al. Varicocele and semen quality: A retrospective case-control study of 4230 patients from a single centre. Journal of Endocrinological Investigation. 2018;41(2):185–192. doi:10.1007/s40618-017-0713-z.

Agarwal A, Deepinder F, Cocuzza M, et al. Efficacy of varicocelectomy in improving semen parameters: New meta-analytical approach. Urology. 2007;70(3):532–538. doi:10.1016/j.urology.2007.04.011.

Sheehan MM, Ramasamy R, Lamb DJ. Molecular mechanisms involved in varicocele-associated infertility. Journal of Assisted Reproduction and Genetics. 2014;31(5):521–526. doi:10.1007/s10815-014-0200-9.

Kim KH, Lee JY, Kang DH, et al. Impact of surgical varicocele repair on pregnancy rate in subfertile men with clinical varicocele and impaired semen quality: A meta-analysis of randomized clinical trials. Korean Journal of Urology. 2013;54(10):703–709. doi:10.4111/kju.2013.54.10.703.

Birowo P, Tendi W, Widyahening IS, et al. The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis. Heliyon. 2020;6(11):e05439. doi:10.1016/j.heliyon.2020.e05439.

Cannarella R, Shah R, Hamoda TA, et al. Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-and-after data. The World Journal of Men's Health. 2024;42(1):92–132. doi:10.5534/wjmh.230034.

Esteves SC, Miyaoka R, Roque M, et al. Outcome of varicocele repair in men with nonobstructive azoospermia: Systematic review and meta-analysis. Asian Journal of Andrology. 2016;18(2):246–253. doi:10.4103/1008-682X.169562.

EAU Guidelines. Edn. presented at the EAU Annual Congress London 2026. Arnhem, The Netherlands: EAU Guidelines Office; 2026. ISBN 978-94-92671-32-5.

Elzanaty S. Varicocele repair in non-obstructive azoospermic men: Diagnostic value of testicular biopsy—a meta-analysis. Scandinavian Journal of Urology. 2014;48(6):494–498. doi:10.3109/21681805.2014.932839.

Cayan S, Shavakhabov S, Kadioglu A. Treatment of palpable varicocele in infertile men: A meta-analysis to define the best technique. Journal of Andrology. 2009;30(1):33–40. doi:10.2164/jandrol.108.005967.

Turgut H. The effect of varicocelectomy on the pregnancy rate in patients with severe oligospermia. Nigerian Journal of Clinical Practice. 2020;23(12):1744–1747. doi:10.4103/njcp.njcp_173_20.

Al Bakri A, Lo K, Grober E, et al. Time for improvement in semen parameters after varicocelectomy. The Journal of Urology. 2012;187(1):227–231. doi:10.1016/j.juro.2011.09.041.

Vahidi S, Moein M, Nabi A, et al. Effects of microsurgical varicocelectomy on semen analysis and sperm function tests in patients with different grades of varicocele: Role of sperm functional tests in evaluation of treatments outcome. Andrologia. 2018;50(8):e13069. doi:10.1111/and.13069.

Kirby EW, Wiener LE, Rajanahally S, et al. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: A systematic review and meta-analysis. Fertility and Sterility. 2016;106(6):1338–1343. doi:10.1016/j.fertnstert.2016.07.1093.

Esteves SC, Oliveira FV, Bertolla RP. Clinical outcome of intracytoplasmic sperm injection in infertile men with treated and untreated clinical varicocele. The Journal of Urology. 2010;184(4):1442–1446. doi:10.1016/j.juro.2010.06.004.

Qiu D, Shi Q, Pan L. Efficacy of varicocelectomy for sperm DNA integrity improvement: A meta-analysis. Andrologia. 2021;53(1):e13885. doi:10.1111/and.13885.

Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: A systematic review and meta-analysis. Fertility and Sterility. 2021;116(3):696–712. doi:10.1016/j.fertnstert.2021.04.003.

Daitch JA, Bedaiwy MA, Pasqualotto EB, et al. Varicocelectomy improves intrauterine insemination success rates in men with varicocele. The Journal of Urology. 2001;165(5):1510–1513. doi:10.1016/S0022-5347(05)66338-0.

Gokce MI, Gülpınar Ö, Süer E, et al. Effect of performing varicocelectomy before intracytoplasmic sperm injection on clinical outcomes in non-azoospermic males. International Urology and Nephrology. 2013;45(2):367–372. doi:10.1007/s11255-013-0394-2.

Hsiao W, Rosoff JS, Pale JR, et al. Varicocelectomy is associated with increases in serum testosterone independent of clinical grade. Urology. 2013;81(6):1213–1218. doi:10.1016/j.urology.2013.01.060.

Li F, Yue H, Yamaguchi K, et al. Effect of surgical repair on testosterone production in infertile men with varicocele: A meta-analysis. International Journal of Urology. 2012;19(2):149–154. doi:10.1111/j.1442-2042.2011.02890.x.

Turgut H. Early period evaluations after varicocelectomy: Semen analysis and spontaneous pregnancy rates. Journal of Urological Surgery. 2020;7(3):195–199. doi:10.4274/jus.galenos.2020.3333.

Zeng Z, Jiang M, Sun M, et al. Clinical evaluation and comprehensive management strategies for adolescent varicocele. Pediatric Surgery International. 2025;41(1):94. doi:10.1007/s00383-025-05985-0.

Gnech M, van Uitert A, Kennedy U, et al. European Association of Urology/European Society for Paediatric Urology guidelines on paediatric urology: Summary of the 2024 updates. European Urology. 2024;86(5):447–456. doi:10.1016/j.eururo.2024.03.025.

Kaltsas A, Sofikitis N, Dimitriadis F, et al. Why varicoceles recur: Missed venous anatomy and contemporary strategies for salvage. Journal of Clinical Medicine. 2026;15(4):1524. doi:10.3390/jcm15041524.

Rotker K, Sigman M. Recurrent varicocele. Asian Journal of Andrology. 2016;18(2):229–233. doi:10.4103/1008-682X.171578.

Fallara G, Tang S, Pang KH, et al. Treatment of persistent or recurrent varicoceles: A systematic review. European Urology Focus. 2023;9(3):531–540. doi:10.1016/j.euf.2022.11.008.

Yayınlanan

9 Kasım 2026

Lisans

Lisans