Embolization of Varicoceles

The abnormal dilatation of the pampiniform venous plexus is not always symptomatic. It is much more frequent on the left side. It can extend from the spermatic vein up to its anastomosis in the renal vein and the inferior vena cava. It is observed in 10–15 % of the adult male population, and it sometimes can be symptomatic: pain, scrotal swelling, or testicular atrophy. It is also found in 20–40 % of the population of infertile men, but it does not necessarily imply male infertility. Various theories have been developed to explain its responsibility, with respect to alterations in the fertilizing qualities of the sperm: scrotal hyperthermia above all, venous refluxes exposing the testis to adrenal or renal metabolites, consequences of venous stasis on testicle, immunological mechanisms, etc.