What are causes varicocele?

Updated: Jan 02, 2019
  • Author: Wesley M White, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following:

  • The angle at which the left testicular vein enters the left renal vein
  • The lack of effective antireflux valves at the juncture of the testicular vein and renal vein
  • The increased renal vein pressure due to its compression between the superior mesenteric artery and the aorta (ie, nutcracker effect)

Also of importance is that a clinical left varicocele is often accompanied by a subclinical right varicocele. Up to 35-40% of men with a palpable left varicocele may actually have bilateral varicoceles that are discovered upon examination. A 2004 study by Gat et al suggested that up to 80% of men with a left clinical varicocele had bilateral varicoceles revealed by noninvasive radiologic testing. [4]

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