Microsurgical subinguinal varix ligation: Techniques and technical pearls

Varicocele can be defined as dilatation or tortuosity (varicosity) of the veins of the pampiniform plexus. Varicoceles are present in approximately 15% of unselected men, in 40% of men presenting with primary infertility, and a much higher percentage of couples with secondary infertility [1, 2]. Varicoceles are the most commonly seen and correctable cause of male-factor infertility [3]. Tulloch's report in 1955 [4] brought to the forefront the proactive treatment and study of varicoceles in the subfertile male. Previously, many investigators felt that varicocele repair was cosmetic or only halted testicular injury at best. Since this time, many studies have demonstrated that improvement in semen parameters and chance of pregnancy are very possible with surgical repair of varicoceles.