Varicose veins in the testicles

A varicocele is a congenital varicosity of the pampiniform plexus due to an absence of valves in the left internal spermatic vein. Approximately 10% to 15% of men have a left varicocele, which may cause pain, testicular atrophy, and be a cause of male infertility later in life. The condition is detected in as many as 40% of men undergoing an infertility workup and in remaining 50%, of Male Infertility the cause is not found. Spermiography may reveal decreased motility and, in some men, a slight decrease in sperm count.

Traditionally, the diagnosis was made through clinical examination; however, as with other venous reflux disorders, ultrasound has become the mainstay of diagnosis. For diagnosis, we look for abnormal reflux on color Doppler with the Valsalva maneuver, rather than the diameter and number of dilated veins with the patient in the standing position.

The Indications for treatment include infertility in patients with appropriate semen abnormalities, chronic groin pain, testicular atrophy in adolescent varicoceles, and recurrent varicocele after previous repair. Other indications more recently described with variable strength of evidence include low serum testosterone (with or without erectile dysfunction), and enhancement of assisted fertility techniques.