Testicular Varicocele

Abstract

A varicocele is a dilation of the veins of the pampiniform venous plexus. Depending on the screening method, it is found in about 10–20% of the general male population, increasing to 40% in infertile men [125]. A high incidence of varicocele is also found in athletes (about 29%) [126]. Varicocele is ten times more common on the left than on the right side [1]. Their aetiology remains unclear but is probably multifactorial. The majority are due to incompetent valves in the testicular veins, while a minority result from obstruction of the spermatic vein. Secondary varicocele can occur in the presence of renal vein or inferior vena cava thrombosis, renal tumour and, only rarely, involvement of the testicular vein by retroperitoneal tumour or retroperitoneal fibrosis. Neoplasm is the most likely cause of non-decompressible recent/rapid onset varicocele in men over 40 years of age; it is frequently caused by a renal malignancy invading the renal vein [3, 4] (Fig. 6.1).