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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".
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]
A hydrocele testis usually occurs on one side, but can also affect both sides. The accumulation can be a marker of physical trauma, infection, tumor or varicocele surgery, [1] but the cause is generally unknown. Indirect inguinal hernia indicates an increased risk of hydrocele testis.
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Valveless testicular veins are a major contributing factor to varicocele. [1] Since the left testicular vein goes all the way up to the left renal vein before it empties, this results in a higher tendency for the left testicle to develop varicocele because of the gravity working on the column of blood in this vein, compared to the right internal spermatic vein.
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]