Varicocele occurs most often on which side?

Varicocele occurs most often on which side?

• A. Right
• B. Left
• C. Bilateral
• D. No side involvement

Answer: (B)

Varicoceles arise from dilation of the pampiniform venous plexus due to increased venous pressure in the testicular veins. The side most commonly affected is determined by how the gonadal veins drain. The left testicular vein drains into the left renal vein at a right-angle junction and can be subjected to higher hydrostatic pressures, especially with compression of the left renal vein between the aorta and the superior mesenteric artery (the nutcracker phenomenon). This setup makes dilation of the left pampiniform veins more likely. The right testicular vein drains directly into the IVC at a more favorable angle and is exposed to lower upstream pressures, so right-sided varicoceles are much less common and, when present, may indicate another pathology. Bilateral involvement can occur but is not as typical as left-sided varicocele. Thus, varicocele is most often on the left.

Varicoceles arise from dilation of the pampiniform venous plexus due to increased venous pressure in the testicular veins. The side most commonly affected is determined by how the gonadal veins drain. The left testicular vein drains into the left renal vein at a right-angle junction and can be subjected to higher hydrostatic pressures, especially with compression of the left renal vein between the aorta and the superior mesenteric artery (the nutcracker phenomenon). This setup makes dilation of the left pampiniform veins more likely. The right testicular vein drains directly into the IVC at a more favorable angle and is exposed to lower upstream pressures, so right-sided varicoceles are much less common and, when present, may indicate another pathology. Bilateral involvement can occur but is not as typical as left-sided varicocele. Thus, varicocele is most often on the left.