Varicocele is an abnormal dilation of the veins of the pampiniform plexus of the spermatic cord.
It is much more common on the left side due to the anatomical characteristics of the venous drainage.
It can be:
It should ideally be performed with the patient standing.
Varicocele can become more evident with the Valsalva maneuver.
Classically, it can be palpated as a structure resembling a "bag of worms".
In some patients it can be associated with:
But this does not mean that every varicocele causes infertility or that every varicocele should be operated on.
The indication depends on:
When appropriate, surgical repair or embolization can be performed.
Clinical pearl
A varicocele of recent onset, especially if right-sided, that does not disappear when supine or that has atypical features, deserves a targeted evaluation to rule out a secondary cause.
Key concept
Varicocele ≠ automatic surgery. The indication depends on the clinical context.
Andrology does not study sexual function alone. It integrates erectile and ejaculatory function, reproduction, hormonal function, and diseases of the male genital tract.
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