Varikosele Genel Bakış
Özet
Pleksus pampiniformis ve internal spermatik venlerin genişlemesi olarak bilinen varikosel erkek infertiltesinin en sık düzeltilebilir nedenidir(1). Varikoselin prevelansı sağlıklı erkeklerde %15-20, primer infertil erkeklerde prevelansı %35-40, sekonder infertilitedeki prevelansı %80’ler civarındadır(2,3). Varikosel semen analizinde çeşitli düzeylerde hasar, testis hacminde küçülme, leyding hücre fonksiyonlarında bozulmalara neden olarak infertiliteye sebep olabilmektedir(4). Varikosele bağlı infertiliteye ısı artışı, artmış veya azalmış kan akımı, hipoksi, sigara, renal ve adrenal metabolitlerin testise reflüsü, yaş, travma, obezite, aile öyküsü ve uzun süreli ayakta kalma gibi sebeplerin neden olduğu düşünülmektedir(5-8).Varikosel %90 oranında sol tarafta görülürken olguların %10’u ise bilateraldir. Genellikle fizik muayene ile tanısı konulan varikoselin tedavisinde radyolojik, laparoskopik veya açık cerrahi yöntemler kullanılır(11). Mikrocerrahi düşük komplikasyon ve gebelik oranlarındaki yüksek başarı nedeniyle tercih edilmelidir(9,10).
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