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Varicocele

最后审阅: 19 Aug 2025
最后更新: 29 Jul 2025

小结

定义

病史和体格检查

关键诊断因素

  • painless scrotal mass
  • left-sided signs/symptoms
  • small testicle
完整详情

其他诊断因素

  • subfertility/infertility
  • age >12
  • scrotal or groin pain
完整详情

危险因素

  • somatometric parameters (tall/low BMI)
  • family history of varicocele
完整详情

诊断性检查

首要检查

  • clinical diagnosis
完整详情

需考虑的检查

  • scrotal ultrasound with color flow Doppler imaging
  • semen analysis
  • serum follicle-stimulating hormone (FSH) (± GnRH stimulation)
  • serum testosterone
  • DNA fragmentation index (DFI)
  • CT abdomen/pelvis
  • MRI abdomen/pelvis
  • retroperitoneal ultrasound
完整详情

治疗流程

急症处理

adolescent

adult

撰稿人

作者

Jay Ira Sandlow, MD

Professor and Chair

Department of Urology

Medical College of Wisconsin

Milwaukee

WI

利益声明

JIS declares that he has received stock options as a member of the Scientific Advisory Board for Contraline, Inc. and has served as a faculty member on the Vasectomy course for the American Urological Association.

Daniel L. Pelzman, MD

Assistant Professor

Massachusetts General Hospital

Boston

MA

利益声明

DLP declares that he has no competing interests.

鸣谢

Dr Jay Ira Sandlow and Dr Daniel L. Pelzman would like to gratefully acknowledge Dr Jagan K. Kansal, Dr Pravin Rao, Dr Miguel Pineda, Dr John C. Thomas, and Dr Wayne Kuang, previous contributors to this topic.

利益声明

JKK, PR, MP, JCT, and WK declare that they have no competing interests.

同行评议者

Siam Oottamasathien, MD

Assistant Professor

Division of Pediatric Urology

University of Utah

Primary Children's Medical Center

Salt Lake City

UT

利益声明

SO declares that she has no competing interests.

Jeffrey Donohoe, MD

Assistant Professor

Pediatric Urology

Medical College of Georgia

Augusta

GA

Disclosures

JD declares that he has no competing interests.

Daniel H. Williams, MD

Assistant Professor

Department of Urology

Head

Section of Male Infertility and Andrology

University of Wisconsin School of Medicine and Public Health

Madison

WI

Disclosures

DHW declares that he has no competing interests.

Edmund Sabanegh, Jr, MD

Director

Center for Male Fertility

Glickman Urological and Kidney Institute

Cleveland

OH

Disclosures

ES declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Brannigan RE, Hermanson L, Kaczmarek J, et al. Updates to male infertility: AUA/ASRM guideline (2024). J Urol. 2024 Dec;212(6):789-99. Abstract

European Association of Urology. Sexual and reproductive health guidelines. Apr 2025 [internet publication].Full text

Persad E, O'Loughlin CA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021 Apr 23;4:CD000479.Full text  Abstract

European Association of Urology. Guidelines on paediatric urology. Apr 2024 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Paratesticular mass
    • Cord hydrocele
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  • Guidelines

    • Sexual and reproductive health: male infertility
    • Guidelines on paediatric urology
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  • Patient information

    Varicocele

    Fertility problems: some reasons

    More Patient information
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