Resumo
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- massa escrotal indolor
- sinais/sintomas do lado esquerdo
- testículo pequeno
Other diagnostic factors
- infertilidade
- idade superior a 12 anos
- dor escrotal ou na virilha
Risk factors
- parâmetros somatométricos (altura/índice de massa corporal [IMC] baixo)
- história familiar de varicocele
Diagnostic tests
1st tests to order
- diagnóstico clínico
Tests to consider
- ultrassonografia escrotal com dopplerfluxometria colorida
- análise de sêmen
- hormônio folículo-estimulante (FSH) sérico (± estimulação com hormônio liberador de gonadotropina [GnRH])
- testosterona sérica
- índice de fragmentação de ácido desoxirribonucleico (IFD)
- tomografia computadorizada (TC) de abdome/pelve
- RNM de abdome/pelve
- ultrassonografia retroperitoneal
Treatment algorithm
adolescente
adultos
Contributors
Authors
Jay Ira Sandlow, MD
Professor and Chair
Department of Urology
Medical College of Wisconsin
Milwaukee
WI
Disclosures
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
Fellow in Male Reproductive and Sexual Health
Department of Urology
Medical College of Wisconsin
Milwaukee
WI
Disclosures
DLP declares that he has no competing interests.
Acknowledgements
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.
Disclosures
JKK, PR, MP, JCT, and WK declare that they have no competing interests.
Peer reviewers
Siam Oottamasathien, MD
Assistant Professor
Division of Pediatric Urology
University of Utah
Primary Children's Medical Center
Salt Lake City
UT
Disclosures
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.
References
Key articles
Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. J Urol. 2021 Jan;205(1):36-43.Full text Abstract
European Association of Urology. Sexual and reproductive health guidelines. Apr 2024 [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
- Massa paratesticular
- Hidrocele do cordão
- Hérnia inguinal
More DifferentialsGuidelines
- Guidelines on paediatric urology
- Sexual and reproductive health: male infertility
More GuidelinesPatient information
Fertility problems: some reasons
Fertility problems: what treatments work?
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