[Varicocele “Important Points”]
• Typically affects the left testis (because left testicular vein drains into renal vein directly at right angle -high pressure-)
• Often Dull-aching or Dragging pain that is worse after exercise or at the end of the day.
• described as a “Bag of worms”, bluish, disappear on lying down.
• May show impulse on cough.
• May be a presenting feature of renal cell carcinoma (left kidney tumour → occlude the left testicular vein → varicocele).
◘ So, sometimes a stem may describe a varicocele along with renal pain and hematuria → choose renal cell carcinoma.
• Ix → Scrotal doppler ▐ US is diagnostic. “not urgent”.
• Varicoceles are usually managed conservatively. If there are concerns about the testicular function of infertility or persistent severe pain → surgery.