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Varicocele

Summary of Varicocele
A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum due to increased venous pressure. It is the most common cause of scrotal enlargement in adult males. Varicoceles are more common on the left side, since the left spermatic vein drains at a right angle first into the left renal vein and then into the inferior vena cava (IVC). The right angle causes less laminar flow than on the right side, where the spermatic vein drains directly into the IVC. A right-sided varicocele should always raise suspicion for renal cell carcinoma. Varicoceles can lead to infertility by raising local temperature, which damages the Sertoli cells of the seminiferous tubules. On scrotal examination, a 'bag of worms' appearance is seen. The lesion does not transilluminate. Doppler ultrasound will show increased blood flow. Treatment is with varicocelectomy or embolization.

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Pathology

Reproductive system

Male and female reproductive system disorders
Male reproductive system disorders
Female reproductive system disorders
Reproductive system pathology review

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Varicocele

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High Yield Notes
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Varicocele

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A right-sided varicocele might indicate a carcinoma on that side.

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USMLE® Step 1 style questions USMLE

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USMLE® Step 2 style questions USMLE

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A 31-year-old man comes to the office for a fertility evaluation. He and his wife have been trying to conceive for the past year without success. He has also noticed a dull aching pain in his scrotum that is exacerbated when he stands. Examination shows a left-sided scrotal enlargement that decreases in size when the patient is placed in a recumbent position. Based on the patient’s symptoms, which of the following veins is most likely to be occluded?

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