INTRODUCTION
Varicoceles have been recognized as clinical entities for more than a
century but, in the early years, the treatment was exclusively for the
management of pain. After 1952, these lesions were viewed differently
because Tulloch reported that varicoceles may affect male fertility.1
He performed a varicocelectomy on a man with azoospermia, sperm
appeared in the ejaculate over time, and the patient achieved a
pregnancy. In 1955, Tulloch reported his series of varicolectomies on
30 infertile men.2 Three had azoospermia, but the others had varying
sperm densities. Although the study design was crude evaluated by
today’s standards, the author concluded, “From the results obtained,
it seems justifiable where a varicocele is associated with subfertility,
the varicocele should be cured.”

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