Urology
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Varicocoele
Dilatation of testicular veins.
Right testicular vein drains in to Inferior vena cava
Left in to renal vein.
Left sided varicocoele is more common since its lower.
Etiology
Young, thin.
Old- Renal cell carcinoma
Clinical features
Dragging pain
On standing swelling enlarges.
Cough produces impulse in the veins
Valsalva's maneuver produces pulse - blow test- (blowing air via the ears)
Varices Reduces on lying down.
Types
1.Small (palpable on Valsalva's)
2.Medium (palpable without it)
3.Large (visible)
Complications
1. Oligospermia (temperature, hormones)
2. Hydrocele
Treatment-
Surgery
1. Inguinal approach - ligation of
Pampariform plexus
2. Retroperitoneal approach - ligation of one testicular vein.
3. Sub inguinal microscopic varicocelectomy.
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