Patient's question:
What are the symptoms of varicocele, how should it be treated, and what are the consequences if it is not treated in a timely manner?Doctor's answer:
Okay, here is the English translation of the provided text, following your instructions:I. Incidence
Varicocele is the dilation, tortuosity, and elongation of the pampiniform plexus of veins around the spermatic cord. It is more common in young people, occurring mostly between the ages of 16 and 25. The incidence rate is approximately 15%, with 99% occurring on the left side and bilateral cases accounting for about 1%.
II. Etiology
(1) Anatomical factors: Blood from the testes and epididymis returns via the spermatic veins. The spermatic veins can be divided into three groups, which communicate with each other via collateral circulation at the external inguinal ring.
Posterior group: External spermatic vein → Inguinal vein → Femoral vein → External iliac vein.
Middle group: Vas deferens vein → Suprarenal vein → Internal iliac vein.
Anterior group: Internal spermatic vein: Veins from the testes and epididymis primarily return via the pampiniform plexus. The plexus merges within the inguinal canal into 2-4 veins, which pass through the internal inguinal ring into the retroperitoneum to form a single vein, called the internal spermatic vein. The left internal spermatic vein ascends obliquely to enter the inferior vena cava; the right one enters the left renal vein at a right angle. The reason varicoceles are more common on the left side is:
1. The left internal spermatic vein is longer and enters the renal vein at a right angle, causing some resistance to blood flow. The left internal spermatic vein near the left renal vein lacks valves, making it easier for blood to flow backward.
2. The left internal spermatic vein lies behind the sigmoid colon and is easily compressed by feces in the intestine, affecting blood return.
(2) Physiological factors: Young and middle-aged adults often have more active sexual function, leading to abundant blood supply to the contents of the scrotum. Therefore, some varicoceles may gradually disappear with age. Additionally, prolonged standing increases abdominal pressure, which is also a contributing factor.
(3) Other factors: Abdominal