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Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. [5] Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. [5] Large varicoceles present as plexus of veins and may be described as a "bag of worms".
Pathophysiology [ edit ] While varicocele is the diagnostic term for swelling in the valveless venous distribution of the male pampiniform plexus , this embryological structure, common to males and females, is often incidentally noted to be swollen during laparoscopic examinations in both symptomatic and asymptomatic females. [ 1 ]
Chronic scrotal pain (pain for greater than 3 months) may occur due to a number of underlying conditions. [3] It occurs in 15-19% of men post vasectomy, due to infections such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele, spermatocele, polyarteritis nodosa, testicular torsion, previous surgery and trauma. [3]
Less commonly, but not exceptionally, varicose veins can be due to other causes, such as post-phlebitic obstruction or incontinence, venous and arteriovenous malformations. [18] Venous reflux is a significant cause. Research has also shown the importance of pelvic vein reflux (PVR) in the development of varicose veins.
An unusual manifestation of NCS includes varicocele formation and varicose veins in the lower limbs. [9] Another clinical study has shown that nutcracker syndrome is a frequent finding in varicocele-affected patients and possibly, nutcracker syndrome should be routinely excluded as a possible cause of varicocele and pelvic congestion. [10]
While varicocele is the diagnostic term for swelling in the valveless venous distribution of the male pampiniform plexus, this embryological structure, common to males and females, is often incidentally noted to be swollen during laproscopic examinations in both symptomatic and asymptomatic females. [2]
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Varicocele is a condition of swollen testicle veins. [27] It is present in 15% of normal men and in about 40% of infertile men. It is present in up to 35% of cases of primary infertility and 69–81% of secondary infertility. [28] Hypogonadotropic hypogonadism due to various causes Obesity increases the risk of hypogonadotropic hypogonadism. [29]