Varicocele

A varicocele is an enlargement of the veins of the pampiniform plexus in the spermatic cord and usually appears in children over 12 years old or around the onset of puberty.

Varicocele looks and feels best when the patient is standing and is characterized by resembling a bag of worms. They are usually on the left side (80 to 90%).

The normal scrotal temperature is 33°C (4°C below body temperature). This is the optimal temperature for spermatogenesis. Relative infertility cannot be assessed until late adolescence but secondary atrophy of the ipsilateral testis is well recognized, and if the affected testis is smaller than the contralateral testis, then early surgical intervention is indicated. A reasonable guideline for intervention is when there is a 2 to 3 cc volume difference or a 20% volume loss in the affected testicle. A relative indication is if the varicocele is particularly large or if the patient has self-esteem problems.

Atlas of Human Anatomy 7th Ed - FH Netter - ISBN 978-0-323-39322-5
Atlas of Human Anatomy 7th Ed - FH Netter - ISBN 978-0-323-39322-5
Laparoscopic varicocelectomy (Palomo Technique)

Laparoscopic varicocelectomy (Palomo Technique)

Operative Pediatric Surgery 7º Ed - L Spitz, AG Coran - ISBN: 978-1-4441-6501-2

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SCIENTIFIC EVIDENCE
* JM Hutson, M O’Brien, SW Beasley, WJ Teague, SK King. Jones’ Clinical Paediatric Surgery 7º Ed.
* MM Ziegler, RG Azizkhan, D von Allmen, TR Weber. Operative Pediatric Surgery 2º Ed.