Progress of the pathogenesis in varicocele: a narrative review

Liang Dong^1,#, Jialu Xin^1,#, Jingyi Zhang², Zheng Liu², Junjun Li^3,*, Xujun Yu^1,*
1 School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
2 TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
3 Assisted Reproduction Medicine Center, Chengdu Fifth People’s Hospital/The Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China
* Corresponding Author: Junjun Li. Email: email ; Xujun Yu. Email: email
# These authors contributed equally to this work

Canadian Journal of Urology https://doi.org/10.32604/cju.2025.068263

Received 24 May 2025; Accepted 27 October 2025; Published online 02 December 2025

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Abstract

Varicocele (VC) is widely recognized as a prevalent and clinically significant cause of male infertility. However, the comprehensive pathogenic mechanisms underlying VC development and progression remain incompletely understood, creating an important knowledge gap in the field of andrology. This review establishes that VC pathogenesis centers on abnormal vascular remodeling and integrates multiple contributing elements, including anatomical abnormalities, biochemical disturbances, genetic factors, low body mass index (BMI), age, and specific sports habits, while secondary varicoceles are primarily induced by compressive pathologies. Through a systematic synthesis of current evidence and recent advances, this review aims to elucidate the complex pathogenic network of VC and provide valuable insights to guide future research directions and inform the development of targeted clinical applications.