Abnormal enlargement of the pampiniform venous plexus in the scrotum
Clinical presentation
Usually asymptomatic
May present having felt a lump
Large varicoceles present as plexus of veins and may be described as 'bag of worms'
Most commonly affects the left side of the scrotum, due to increased resistance to flow
Left gonadal vein drains into the left renal vein whereas the right gonadal vein drains directly into the inferior vena cava
In renal cell carcinoma, the tumour may invade the left renal vein and cause blockage leading to variceal veins downstream in the left scrotum - a left sided varicocele can also be a presenting feature of RCC
Management
Generally need no treatment
If causing pain or swelling consider surgical management
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