Internal Spermatic Vein Histopathology in Patients Undergoing Varicocelectomy

Varicocele is an enlargement of the veins around the testicle and may affect male fertility. This prospective observational study will include men with varicocele who are undergoing varicocelectomy. The study aims to examine whether changes in the structure of the internal spermatic veins are related to clinical findings, semen analysis results, and scrotal duplex ultrasound findings. During varicocelectomy, vein tissue that is removed as part of the surgical procedure will be collected and examined under a microscope. Digital image analysis will also be used to measure different features of the vein wall, including its thickness and the amounts of smooth muscle and collagen. In participants undergoing surgery for varicocele on both sides, the findings from the left and right spermatic veins will also be compared. The study does not assign participants to varicocelectomy; the decision to perform surgery is based on their clinical care.

Inclusion Criteria: * Male patients with clinically palpable varicocele. * Scheduled for varicocelectomy. * Preoperative scrotal duplex ultrasonography available. * Preoperative semen analysis available. * Written informed consent for participation. Exclusion Criteria: * Previous varicocelectomy on the affected side. * Previous major scrotal or testicular surgery affecting the study side. * Obstructive causes of azoospermia, when applicable to the semen analysis component. * Hormonal treatment that may significantly alter semen parameters. * Incomplete clinical, duplex ultrasound, or semen analysis data. * Declines participation.