Varicocele: Difference between revisions
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**Does not trans-illuminate | **Does not trans-illuminate | ||
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[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 10:54, 1 August 2015
Background
- Peak incidence: onset of puberty
- Dilatation of spermatic cord veins (pampiniform plexus)
- ~90% occur on left due to 90 degree turn at renal vein [1]
- Can impair sperm production/function[2]
- Sudden appearance may be related to renal malignancy obstructing venous return
Diagnosis
- Dullness/heaviness/scrotal discomfort
- Physical exam
- "Bag of worms"
- More prominent w/ standing or Valsalva
- Does not trans-illuminate
Differential Diagnosis
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Treatment
- Scrotal support
Disposition
- Referral to urologist
- Implications of possible subfertility should be discussed by urologist