Varicocele

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- Left: Transverse view of the left testis shows multiple cystic-appearing spaces lateral to the testis ; they communicated with each other during real-time scanning, and measure >2 mm in size
- Right: color doppler during the Valsalva maneuver shows readily detected flow
- Diagnosis should be made when peritesticular veins measure > 2 mm in size, and/or valsalva-augmented flow persists > 1 s
- Varicoceles generally do not cause pain or discomfort unless large
- However, even non-palpable varicoceles can potentially cause infertility, and are treatable (coiling shown above)
- 85% of varicoceles are left-sided, presumably because the left spermatic vein drains into the left renal vein
- An isolated right-sided varicocele should prompt a search for a compressive, retroperitoneal mass (or possibly situs inversus)