Varicocele: Difference between revisions
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==Background== | ==Background== | ||
#dilatation of pampiniform plexus and internal spermatic vein-occurs in 15-20% of all fertile males, 40% of infertile males | |||
#80-90% occur on L due to anatomy | |||
#large (easily visualized), moderate (upon palpation), and small (palpable w valsalva) | |||
#can impair sperm production/function | |||
#sudden appearance can be related to renal malignancy causing obstruction of venous return. | |||
#nutcracker syndrome - when SMA compresses L renal vein causing varicocele. | |||
==Diagnosis== | ==Diagnosis== | ||
#hx: worse w standing/valsalva. feeling of dullness/heaviness. scrotal discomfort.-doppler ultrasound. vein = 3mm or larger ==Work-Up== | |||
#physical exam ("bag of worms"). have the pt valsalva-may cause ipsilateral testicular atrophy-ultrasound ==DDx== | |||
#hydrocele, hematocele, spermatocele-malignancy. sertoli-leydig, testicular ca-abscess | |||
==Treatment== | |||
#scrotal support | |||
#Surgical tx if palpable and continued pain, infertility. varicocelectomy. ==Disposition== | |||
#if scrotal u/s confirm presence of only varicocele. followup as outpt w urology, non-urgent. | |||
==Source== | ==Source== | ||
Adapted from(emed, mayo, utd) | |||
Adapted from | |||
[[Category:GU]] | [[Category:GU]] | ||
Revision as of 13:31, 14 March 2011
Background
- dilatation of pampiniform plexus and internal spermatic vein-occurs in 15-20% of all fertile males, 40% of infertile males
- 80-90% occur on L due to anatomy
- large (easily visualized), moderate (upon palpation), and small (palpable w valsalva)
- can impair sperm production/function
- sudden appearance can be related to renal malignancy causing obstruction of venous return.
- nutcracker syndrome - when SMA compresses L renal vein causing varicocele.
Diagnosis
- hx: worse w standing/valsalva. feeling of dullness/heaviness. scrotal discomfort.-doppler ultrasound. vein = 3mm or larger ==Work-Up==
- physical exam ("bag of worms"). have the pt valsalva-may cause ipsilateral testicular atrophy-ultrasound ==DDx==
- hydrocele, hematocele, spermatocele-malignancy. sertoli-leydig, testicular ca-abscess
Treatment
- scrotal support
- Surgical tx if palpable and continued pain, infertility. varicocelectomy. ==Disposition==
- if scrotal u/s confirm presence of only varicocele. followup as outpt w urology, non-urgent.
Source
Adapted from(emed, mayo, utd)