Macroscopic Surgical Techniques for Varicocele Repair

  • Sarah C. Krzastek
  • Connor Rotterman
  • Ryan P. Smith
  • Jason R. KovacEmail author


Clinical varicoceles are associated with chronic scrotal pain, failure of testicular growth and development, testicular atrophy, hypogonadism, and male-factor infertility. The repair of clinically significant varicoceles has been shown to improve these parameters, and surgical varicocele repair is currently the most commonly performed operation for treatment of male-factor infertility. Various treatment modalities exist for varicocele repair, including embolization and surgical ligation. Surgical ligation may be performed by either a microscopic or macroscopic approach. While the microscopic varicocele repair remains the gold standard of surgical management, an understanding of macroscopic repairs is important to guide management. The aim of this chapter is to provide an understanding of the various techniques of macroscopic varicocele repairs with specific attention paid to the open inguinal and subinguinal approaches.


Macrosurgery Open varicocele repair Laparoscopy Palomo repair Inguinal Subinguinal 



Assisted reproductive techniques


American Urological Association




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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sarah C. Krzastek
    • 1
  • Connor Rotterman
    • 2
  • Ryan P. Smith
    • 1
  • Jason R. Kovac
    • 2
    Email author
  1. 1.Department of UrologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Men’s Health CenterIndianapolisUSA

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