Painful varicocele in an infertile man

摘要

The patient has a varicocele, which is an abnormal, tortuous dilatation of the pampiniform plexus of testicular veins. It occurs in 10%—15% of men, rising to about 25% of men with an abnormal semen analysis.1 Many varicoceles develop in adolescence, and up to 90% are left-sided.2 Most varicoceles are painless and idio-pathic. It has been postulated that they arise because of a lack of venous valves, subsequent reflux and raised testicular venous pressure. Increased spermatic DNA damage has been shown in patients with varicoceles.