Varicocele and male infertility : recent advances in diagnosis and therapy

I. Epidemiology.- Epidemiology of Idiopathic Varicocele.- II. Basic Aspects.- Pathogenesis of Varicocele.- The Varicocele: Clinical Aspects.- "Orchipathia e varicocele".- Histological, Morphometrical, and Enzyme Histochemical Studies on Varicocele Orchiopathy.- Varicocele and Seminal Cytology.- Cases Illustrating the Variation of Results.- III. Diagnosis.- A. Phlebography.- Technique of Retrograde Phlebography of the Internal Spermatic Vein.- Radiologic Anatomy of the Left Testicular Vein in Varicoceles.- Phlebography of the Right Spermatic Vein in Varicoceles.- Technique, Indications, and Results of Transfemoral Phlebography of the Testicular Vein in Persistent Varicocele.- B. Other Methods.- The Value of Physical Examination for the Diagnosis of Varicocele.- Contact Thermography in the Diagnosis of Varicocele.- The Doppler Technique for the Diagnosis of Varicocele.- Diagnosis and Differential Diagnosis of Varicocele by Ultrasound.- Comparison Between Different Methods for the Diagnosis of Varicocele.- IV. Endocrinology and Immunology.- Hormone Levels and Sperm Counts in Patients with Varicocele.- Testosterone in Peripheral Plasma, Spermatic Veins, and Testicular Tissue of Patients with Varicocele.- Varicocele Operation and Endocrine Parameters.- Hormonal Testicular Function in Patients with Varicocele.- Enhanced Chemotactic Activity of Microphages in Varicocele.- V. Therapy.- A. Surgical Treatment.- Surgical Treatment of Varicocele.- Recidivation of Varicocele, Prophylaxis, and Therapy.- Persisting Varicocele: Cause and Treatment.- B. Sclerotherapy.- Results of Transfemoral Testicular Vein Obliteration Using a Balloon Catheter.- Sclerotherapy: Technique and Results.- C. Embolization.- The Treatment of Idiopathic Varicocele by Transfemoral Spiral Occlusion of the Left Testicular Vein.- Treatment of Varicoceles by Embolization with Detachable Balloons.- Nonsurgical Cure of Varicocele by Transcatheter Embolization of the Internal Spermatic Vein with Bucrylate.- Modified Technique for Embolization of the Internal Spermatic Vein.- D. Complications and Risks.- Complications of Surgery for Varicocele.- Complications and Risks of Percutaneous Sclerotherapy.- VI. Results.- Long-Term Results after Surgical Treatment of an Idiopathic Varicocele.- Spermatologic Results Preceding and Following Varicocele Surgery.- Treatment of Idiopathic Varicoceles by Transfemoral Testicular Vein Occlusion.- Effects of Percutaneous Sclerosis of the Left Internal Spermatic Vein on Semen Quality.- VII. Discussion.- Phlebography of Persistent Varicocele in Boys.