Renal & Urology/ Varicocele

Question 1

What are varicoceles?

Answer 1

Dilated veins in the pampiniform plexus from increased venous pressure and incompetent valves

Question 2

On which side are varicoceles typically seen?

Answer 2

• 90% occur on the left side
• because the left spermatic vein enters the left renal vein at a 90° angle while the right spermatic vein enters the inferior vena cava (IVC) more obtusely allowing for smoother flow

Question 3

What percentage of males with varicoceles will develop fertility problems?

Answer 3

10%-15%

Question 4

What signs are seen with varicoceles?

Answer 4

• varicoceles feel like a “bag of worms”
• enlarge with Valsalva
• typically decrease when the patient is supine

Question 5

When should you be concerned about a secondary varicocele?

Answer 5

Persists in the supine position, acute onset, right sided

Question 6

What conditions can cause secondary varicoceles?

Answer 6

• IVC thrombus
• right renal vein thrombus
• abdominal mass (retroperitoneal tumor or kidney tumor)