ABSTRACT
A varicocele is an abnormally dilated and tortuous pampiniform plexus, the venous complex that flows into the spermatic veins. Varicocele is present in 15% of the male population and not present prior to puberty (1-3). The majority of cases are thought to be due to absent or incompetent valves in the proximal internal spermatic vein with leftsided predominance linked to the higher venous pressures in the left internal spermatic venous system. The right spermatic vein enters the vena cava at an oblique angle, while the left spermatic vein enters the left renal vein at a right angle. The left venous insertion is also 8 to10 cm more cephalad than the insertion on the right. Both factors presumably increase the hydrostatic pressure within the left spermatic vein when compared with the right (1). Approximately 90% of unilateral varicoceles are left-sided, although bilateral varices may be found in 50% of patients (4, 25).
