Editorial Comment from Dr Zampieri to Varicocele is associated with varicose veins: A population-based case-control study.

Abstract

From a urological and andrological point of view, varicocele is the first cause of impaired fertility potential. Data from the present study show a correlation between varicocele and varicose veins.1 Even if this association is based on an “electronic” diagnosis of varicocele and varicose veins after the International Classification of Diseases classification, some interesting results and some critical points should be discussed. As reported by the authors, there is no evidence of bilateral or unilateral varicocele, and there are no data about comorbid factors, such as body mass index, smoking status or sport activities. My critical point is that there are no data about the grade of varicocele and the grade of varicose veins.2-4 The prevalence of varicocele is higher in adolescence than in adulthood, whereas the incidence of varicose veins is higher in adulthood, and the authors reported that this association is higher in patients aged <50 years. The authors suggest that patients with varicose veins should also be followed for varicocele, but it should probably be suggested to also follow patients with varicocele to avoid varicose veins that are associated with other complications, such as thrombosis, phlebitis and so on in adulthood. Another critical point is that they reported that the prevalence of male infertility is higher in patients with varicocele and varicose veins in respect to patients with varicocele alone, but they did not comment on how they found this correlation. Fertility potential depends on different factors, and it is difficult to obtain data about fertility with only an International Classification of Diseases code. I believe that this study is the basis for further research in the field, especially to find comorbidity using the International Classification of Diseases classification. None declared.