Varicocele: Pathogenesis and clinical findings
Primary:
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Description

Varicocele: Pathogenesis and clinical findings

Primary:

 - Anatomically: the left spermatic vein drains into the left renal vein

 - Nutcracker Effect: The left renal vein can get pinched by the abdominal aorta and superior mesenteric artery Backup of blood in left renal vein

 - Increased pressure in left spermatic vein

Secondary:

 - Renal cell carcinoma or retroperitoneal masses

 - Inferior vena cava thrombus

 - External compression of spermatic vein

 - Obstruction of blood flow

 - Increased spermatic vein pressure

-> Vein valve leaflet failure & retrograde bloodflow back towards testicle

-> Dilation of pampiniform plexus and scrotal vein plexus

-> Varicocele

Notes:

 • 90% present as left sided.

 • Primary varicocele ache and scrotal venous distention can be relieved by superincumbent positioning (increases venous return).

 • Small varicoceles can be identified by preforming the Valsalva maneuver (decreases venous return).

 • Unilateral right varicoceles are uncommon and should be investigated for underlying pathology causing obstruction.



#Varicocele #Pathophysiology #Signs #Symptoms #Urology #Diagnosis
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The Calgary Guide to Understanding Disease
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Account created for The Calgary Guide to Understanding Disease - Linking pathophysiology to clinical presentation - http://calgaryguide.ucalgary.ca/
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