[Left-side varicocele and infertility: diagnosis and treatment]

Eighty-four patients with left varicocele were subjected to complex examination to identify the causes of disturbed spermatogenesis. It was found that not only the testis but the adrenal also is involved in the pathological process in varicocele caused by venous renal hypertension. Changes of venous hemodynamics in the left adrenal lead to activation of steroidogenesis in its cortex and, consequently, to impairment of spermatogenesis in both testes. As the result of the study a new method for the treatment of sterility in patients with left varicocele was suggested, namely, X-ray-guided endovascular occlusion of the central vein of the left adrenal. Tentative evaluation of the results of the intervention gives hope of its efficacy.