Varicocoele

Question 1

Define varicocoele

Answer 1

Abnormal dilation of the internal spermatic veins and pampiniform plexus that drain the testes

Question 2

What are the causes/risk factors of varicocoele?

Answer 2

• Increased hydrostatic pressure in left renal vein
• Incompetent/genetically absent valves
• Most common on left side (90%) – left spermatic vein enters left renal vein at 90°

Question 3

What are the signs and symptoms of varicocoele?

Answer 3

• Painless scrotal mass “bag of worms”
Affected side hang lower  
• May reduce in lying  
• Valsalva increase dilatation  
• Cough impulse

Question 4

What investigations are carried out for varicocoele?

Answer 4

• Sperm Count - done as part of fertility investigation

* Colour Doppler Scan - presence of varicocele; identification of sub-clinical varicocele.