Small Vessel Alterations in the Testes of Infertile Men with Varicocele

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Abstract
Small vessel fibrosis and lumen narrowing is documented in testicular biopsy specimens from two of six subfertile men with varicocele. Venular occlusion is associated with several histologic features including enlarged endothelial cells, collagenation of vessel walls, perivascular fibrosis, and, less frequently, myoepithelial cell proliferation and perivascular lymphocytic infiltrates. Ultrastructural study revealed enlarged endothelial cells with complex cellular junctions and deposition of collagen in vessel wails and perivascular spaces. In patients with varicocele, altered testicular blood flow due to venous stasis and small vessel occlusive disease may contribute to Leydig and/or germinal cell dysfunction and subsequent infertility.