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Varicocele

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Topic updated on 06/09/17 12:31pm

Overview
 

 
Introduction
  • A 54-year-old man present with a mass in his scrotum. He reports it feels like it is filled with worms.
Introduction
  • Varicose veins in testicle due to failure of vein valves in pampiniform plexus
    • more common on the left side due to high pressures in testicular vein draining into left renal vein 
  • Common condition affecting approximately 20% of men
  • Occur in young men
    • usually during the second or third decade of life
Presentation
  • Symptoms
    • may be asymptomatic
    • pain
    • atrophy (shrinkage)
  • Physical exam
    • bag of worms appearance in scrotum
Evaluation
  •  Ultrasound
Treatment
  • Surgery
    • varicocele embolization
Prognosis, Prevention, and Complications
  •  Fertility problems
    • ↑ temperature of epididymis ↓ viable sperm count


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Qbank (1 Questions)

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(M1.RP.31) A 27-year-old male presents with primary complaints of a palpable mass in his scrotum and mild testicular pain. Physical exam reveals an abnormal appearing scrotum around the left testis, as depicted in image A. Which of the following is the most likely etiology of this presentation? Topic Review Topic
FIGURES: A          

1. Compression of the left renal vein at the aortic origin of the superior mesenteric artery
2. Patent processus vaginalis allowing fluid entry into the scrotum
3. Neisseria gonorrhoeae Infection of the left testis leading to epididymitis
4. Unilateral failure of the left testis to descend into the scrotum
5. Twisting of the spermatic cord secondary to rotation of the left testis

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