VaricoceleI86.1
Synonym(s)
Varices of the scrotum
DefinitionThis section has been translated automatically.
Varicose enlargement of the pampiniform plexus formed by the internal sperm vein and its collaterals.
ClassificationThis section has been translated automatically.
Classification according to WHO criteria.
| Grade 0 | subclinical varicocele (detection only possible by Doppler sonography) |
| Grade I | varicocele visible or palpable under Valsalva press maneuver |
| Grade II | palpable varicocele (not visibly dilated venous convolute) |
| Grade III | varicocele visible through the scrotal skin in standing and lying position |
Occurrence/EpidemiologyThis section has been translated automatically.
In 5-25% of children and adolescents and 8-10% of men. More common in fertilisation patients (25-40%).
LocalizationThis section has been translated automatically.
Due to the anatomical conditions almost always on the left side (opening of the left spermatic vein into the valveless renal vein on the left).
Clinical featuresThis section has been translated automatically.
- WHO grade 0-II: Often asymptomatic.
- WHO Grade III and IV: Mostly painless bulging, spherical swelling of the testis with a dull feeling of tension on the affected side of the testis. Occasional pain when standing or walking. If the findings are pronounced, fertility may be impaired ( OAT syndrome).
DiagnosisThis section has been translated automatically.
Clinical, palpation and Doppler sonography.
Differential diagnosisThis section has been translated automatically.
Hydrocele, testicular tumors, scrotal hernias
TherapyThis section has been translated automatically.
- Simple resection: High inguinal resection of the Vv. spermaticae according to Bernardi in the region of the inguinal ring. Alternatively, retroperitoneal resection of the spermatic vein according to Palomo.
- Interventional radiology: Occlusion of the spermatic vein with a metal spiral. Transcutaneous, femoral sclerotherapy, which should lead to obliteration of the internal spermatic vein with simultaneous phlebographic imaging of the opposite side (asymptomatic subclinical varicocele of the opposite side up to 30%). For recurrent varicocele after surgery, phlebography and radiological venous occlusion is the method of choice.
LiteratureThis section has been translated automatically.
- Aridogan IA et al (2003) Comparison of fine-needle aspiration and open biopsy of testis in sperm retrieval and histopathologic diagnosis. Andrologia 35: 121-125
- Baker et al (1985) Testicular vein ligation and fertility in men with varicoceles. Br Med J 291: 1678-1680
- Evers JIH, Collins JA (2003) Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 361: 1849-1853
- McAndrew HF et al (2002) The incidence and investigation of acute scrotal problems in children. Pediatric Surgery Int 18: 435-437
- Haidl G et al (2002) Guidelines for varicocele management. dermatologist 53: 534-535
- Hauser R et al (2001) Varicocele: effect on sperm functions. Hum Reprod Update 7: 482-485
- Stavropoulos NE et al (2002) Varicocele in schoolboys. Arch Androl 48: 187-192