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Intratesticular varicocele

Case contributed by Mostafa Elfeky
Diagnosis certain

Presentation

Married for three years with primary infertility. History of bilateral inguinal undescended testes that were treated surgically at 2 years old. Serial semen analysis revealed azoospermia

Patient Data

Age: 30 years
Gender: Male

Scrotum

ultrasound

Left testis is small in size averaging 9.4 cc in volume. It shows multiple intratesticular venous channels reaching 2.7 mm in caliber with evident reflux on Valsalva maneuver. Extratesticular varicocele is also noted reaching 5 mm in caliber.

Right testis is smaller in size averaging 5.5 cc in volume. No varicocele.

Case Discussion

Most reported cases are seen on left testis and are usually associated with ipsilateral extratesticular varicocele. There is reported increased incidence in men who had undergone prepubertal orchidopexy for undescended testis 1.

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