Intratesticular varicocele

Case contributed by Dr Rupesh Namdev

Presentation

Oligospermia, left testicular pain with feeling of heaviness, clinically small left testis

Patient Data

Age: 30 years
Gender: Male
Modality: Ultrasound

Longitudinal B-mode and color doppler scan of left testis show prominent tortuous tubular structures  extending from the mediastinum towards the periphery showing venous flow consistent with diagnosis of intratesticular varicocele. Reflux was seen during Valsalva. Also there is extratesticular varicocele noted.

Case Discussion

Intratesticular varicocele is a rare entity seen as dilated intratesticular veins usually seen in relation to the mediastinum testis. It is usually seen in the presence of ipsilateral extratesticular varicocele.

Most of the reported cases of intratesticular varicocle occur on the left side as is the case with extratesticular varicocele. The testicular pain is attributed to the stretching of tunica albuginea after active and passive congestion and dilatation of veins 1.

The three commonly recognisable patterns of intratesticular varicocele on ultrasound studies are:

  • tubular (most common)
  • cystic
  • mixed

Increased incidence is noted in men who had undergone prepubertal orchidopexy for acquired undescended testis 2.

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Case Information

rID: 27305
Case created: 28th Jan 2014
Last edited: 1st Jan 2016
System: Urogenital
Inclusion in quiz mode: Included

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