A chronic dilatation of veins around the testes that develops because the gonadal veins that drain from the testicle to the upper retroperitoneum lack internal valves.

A varicocele of the right side is uncommon, because the angle of the insertion of the right gonadal vein into the vena cava causes a functional valve effect, so the venous pressure is generally remains low.

Rarely am a cute development of a varicocele provides a clue to compression of the vena cava or impediment to blood flow in the gonadal vein.

If an acute varicocele occurs on the right side, its suggest a retroperitoneal process and concerns about a testicular cancer.

A varicocele is an enlargement of the veins within the scrotum.

The scrotal veins are called the pampiniform plexus.

A varicocele develops from veins that carry blood away from the testicles and toward the heart.

With varicoceles there is an abnormality in the venous valves and backup of the blood can occur causing the veins near the testicle to dilate.

It can decrease sperm production and quality, and in some cases can lead to infertility.

Varicoceles are the most common cause of male infertility.

Varicocele is present in 15% of normal men and in about 40% of infertile men.

It is present in up to 35% of cases of primary infertility and 69–81% of secondary infertility.

Veins surrounding the testicle function to drive heat away from the testicles and a varicocele can cause the testicles to overheat and negatively affect sperm production.

Varicoceles can result in decreased sperm quality and quality as well as lower testosterone levels.

It can also shrink the testicle size.

They are common.

Found in 15 percent of the adult male population and around 20 percent of adolescent males.

Occur more likely in patients if a father or brother has a varicocele.

Varicoceles are more common in males aged 15 to 25.

Generally form during puberty.

More common found on the left side of the scrotum.

Bilateral varicoceles our rare.

Not all varicoceles affect sperm production.

The spermatic cord which holds up each testicle, contains veins, arteries, and nerves supporting each testicular gland.

Blood pooling in the scrotal veins cause the veins to enlarge and develop into a varicocele.

Its cause is unclear.

There are no established risk factors.

It may be asymptomatic.

Signs/symptoms include:

a lump in the testicles

swelling of the scrotum

visibly enlarged or twisted veins in the scrotum,

a dull, recurring pain in the scrotum

It is present in 35 to 44 percent of men with primary infertility and in 45 to 81 percent of men with secondary infertility.

Primary infertility is generally used to refer to a couple that hasn’t conceived a child after at least one year of trying.

Secondary infertility describes couples that have conceived at least once but aren’t able to again.

Varicoceles are classified it with one of three clinical grades, according to their size., with Grade 1 is the smallest and grade 3 the largest.

Clinically grade 3 varicoceles can be easily felt and often seen and can feel like a bag of worms next to the testicles.
Large varicoceles can cause dull pain in the testicles and scrotum.

Diagnosis is by physical examination, and an ultrasound is generally not needed.

Treatment options are based on the degree of discomfort or infertility issues and not size

It’s not always necessary to treat a varicocele.

Treatment if the varicocele is associated with:


testicular atrophy


Sperm production can be improved with early treatment.

Wearing tight underwear or a jock strap can sometimes provide support that alleviates pain or discomfort.

A varicocelectomy clamps or ties off the abnormal veins.

In varicocele embolization places a small catheter into a groin or neck vein, and a coil is then placed into the catheter and into the varicocele blocking blood from getting to the abnormal veins.

Treatment options include: surgery-varococelectomy laparoscopic surgery, embolization, microsurgical subinguinal varicocele repair.
The goal of treatments is to tie off a block of veins involved in the lesion and return testicle function to normal.
Varicocelectomy is 80-90% effective for controlling pain.
For men with infertility 70% have improvement in sperm production in as little as 3-6 months with the above surgery.

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