Varicocele

Question 1

Define:

Answer 1

Dilated veins of the pampiniform plexus forming a scrotal mass

Question 2

Aetiology/risk factors:

Answer 2

80-90% will occur on the left hand side due to:

• The angle the left testicular vein joins the left renal vein
• Lack of effective valves between the left testicular vein and renal vein
• increased reflux from compression of the renal vein
• Venous incompetence (like varicose veins)

Question 3

Symptoms:

Answer 3

Usually asymp 2-10% have symptoms but usually an incidental finding

Scrotal heaviness

Scrotum feels like a bag of worms

Often distended scrotal blood vessels

May feel dull ache

Question 4

Signs:

Answer 4

MUST BE STANDING FOR EXAMINATION AS SWELLING DISAPPEARS ON LYING DOWN.

cough impulse

Valsalva manoeuvre increases dilatation

Side with the varicocele will hang lower

Question 5

Investigations:

Answer 5

Sperm count

Colour doppler scan