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Friday, February 27, 2009

A isolated right sides varicocele

Someone asked me this the other day: can an isolated right sides varicocele be a sign of something bad?

Yes it can be caused by a large right sided renal mass, at least according to the textbooks, because in practice--since 2000--I have never seen an isolated right varicocele be associated with a renal mass.

But here is why it can happen:
  • On the left side, the testicular vein drains into the left renal vein.  The insertion of the testicular vein into the renal vein forms right angle and blood backs up.  When venous blood backs up, varicose veins form.  Varicoceles are varicose veins of the testicle.
  • On the right side, the right testicular vein drains directly into the vena cava, which is the bodies largest vein.  Blood rarely ever backs up here, but if the vein is occluded, say from a large renal cancer, it can.  In this case, the man would develop an isolated right varicocele.
Bilateral varicoceles are common and not associated with kidney cancer.

Disclaimer:  this post is meant to be educational only.  It does not indicate or imply that any medical advice is being given.  No doctor-patient relationship exists.  If the reader is concerned, seek the advice of a doctor.