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
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.