When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Varicocele

Última revisão: 2 Aug 2025
Última atualização: 29 Jul 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • massa escrotal indolor
  • sinais/sintomas do lado esquerdo
  • testículo pequeno
Detalhes completos

Outros fatores diagnósticos

  • subfertilidade/infertilidade
  • idade superior a 12 anos
  • dor escrotal ou na virilha
Detalhes completos

Fatores de risco

  • parâmetros somatométricos (altura/índice de massa corporal [IMC] baixo)
  • história familiar de varicocele
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • diagnóstico clínico
Detalhes completos

Investigações a serem consideradas

  • ultrassonografia escrotal com dopplerfluxometria colorida
  • análise de sêmen
  • hormônio folículo-estimulante (FSH) sérico (± estimulação de GnRH)
  • testosterona sérica
  • índice de fragmentação de ácido desoxirribonucleico (IFD)
  • tomografia computadorizada (TC) de abdome/pelve
  • RNM de abdome/pelve
  • ultrassonografia retroperitoneal
Detalhes completos

Algoritmo de tratamento

AGUDA

adolescente

adultos

Colaboradores

Autores

Jay Ira Sandlow, MD

Professor and Chair

Department of Urology

Medical College of Wisconsin

Milwaukee

WI

Declarações

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

Declarações

DLP declares that he has no competing interests.

Agradecimentos

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.

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

    • Massa paratesticular
    • Hidrocele do cordão
    • Hérnia inguinal
    More Differentials
  • Guidelines

    • Sexual and reproductive health: male infertility
    • Diagnosis and treatment of infertility in men
    More Guidelines
  • Patient information

    Câncer de testículo

    Varicocele

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer