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Varicocele
Shweta Bhatt, MD; Akshya Gupta, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Dilatation and tortuosity of pampiniform plexus > 3 mm due to congestion and retrograde flow in internal spermatic vein

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • MR Findings

                  • Other Modality Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Bertolotto M et al: Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound. 23(4):487-507, 2020
                                          2. Freeman S et al: Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 30(1):11-25, 2020
                                          3. Gleason A et al: Isolated right-sided varicocele: is further workup necessary? AJR Am J Roentgenol. 212(4):802-7, 2019
                                          4. Cantoro U et al: Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology. 85(4):826-30, 2015
                                          5. Kim YS et al: Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis. Korean J Urol. 56(2):144-9, 2015
                                          6. Karami M et al: Determination of the best position and site for color Doppler ultrasonographic evaluation of the testicular vein to define the clinical grades of varicocele ultrasonographically. Adv Biomed Res. 3:17, 2014
                                          7. MacLachlan LS et al: Intratesticular varicoceles: are they significant? J Pediatr Urol. 9(6 Pt A):851-5, 2013
                                          8. Chen SS: Differences in the clinical characteristics between young and elderly men with varicocoele. Int J Androl. 35(5):695-9, 2012
                                          9. El-Haggar S et al: Ultrasonographic parameters of the spermatic veins at the inguinal and scrotal levels in varicocele diagnosis and post-operative repair. Andrologia. 44(3):210-3, 2012
                                          10. Mohammadi A et al: Varicocele and nutcracker syndrome: sonographic findings. J Ultrasound Med. 2010 Aug;29(8):1153-60. Erratum in: J Ultrasound Med. 30(10):1444, 2011
                                          11. Pauroso S et al: Varicocele: Ultrasonographic assessment in daily clinical practice. J Ultrasound. 14(4):199-204, 2011
                                          12. Evers JL et al: Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet. 361(9372):1849-52, 2003
                                          13. Kutlu R et al: Intratesticular arteriovenous malformation: color Doppler sonographic findings. J Ultrasound Med. 22(3):295-8, 2003
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Dilatation and tortuosity of pampiniform plexus > 3 mm due to congestion and retrograde flow in internal spermatic vein

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • MR Findings

                                                          • Other Modality Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Bertolotto M et al: Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound. 23(4):487-507, 2020
                                                                                  2. Freeman S et al: Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 30(1):11-25, 2020
                                                                                  3. Gleason A et al: Isolated right-sided varicocele: is further workup necessary? AJR Am J Roentgenol. 212(4):802-7, 2019
                                                                                  4. Cantoro U et al: Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology. 85(4):826-30, 2015
                                                                                  5. Kim YS et al: Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis. Korean J Urol. 56(2):144-9, 2015
                                                                                  6. Karami M et al: Determination of the best position and site for color Doppler ultrasonographic evaluation of the testicular vein to define the clinical grades of varicocele ultrasonographically. Adv Biomed Res. 3:17, 2014
                                                                                  7. MacLachlan LS et al: Intratesticular varicoceles: are they significant? J Pediatr Urol. 9(6 Pt A):851-5, 2013
                                                                                  8. Chen SS: Differences in the clinical characteristics between young and elderly men with varicocoele. Int J Androl. 35(5):695-9, 2012
                                                                                  9. El-Haggar S et al: Ultrasonographic parameters of the spermatic veins at the inguinal and scrotal levels in varicocele diagnosis and post-operative repair. Andrologia. 44(3):210-3, 2012
                                                                                  10. Mohammadi A et al: Varicocele and nutcracker syndrome: sonographic findings. J Ultrasound Med. 2010 Aug;29(8):1153-60. Erratum in: J Ultrasound Med. 30(10):1444, 2011
                                                                                  11. Pauroso S et al: Varicocele: Ultrasonographic assessment in daily clinical practice. J Ultrasound. 14(4):199-204, 2011
                                                                                  12. Evers JL et al: Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet. 361(9372):1849-52, 2003
                                                                                  13. Kutlu R et al: Intratesticular arteriovenous malformation: color Doppler sonographic findings. J Ultrasound Med. 22(3):295-8, 2003