Numerous theories have been suggested.
- Left testicular
vein enters the left renal vein perpendicularly
- Long (8
- 10 cm) left testicular vein (aided by gravity)
of left renal vein between aorta and superior mesenteric artery
('nut cracker' effect)
or incompetent valves in testicular vein
Varicocele is noted bilaterally in 20% to 50% of men
Unilateral right-sided varicocele is noted in 15% of men
While all causes suggested are in the abdomen, (high) dilated tortuous
veins are identified only in the scrotal and inguinal region (low)
up to the deep inguinal ring.
with the existing theories of varicocele and the poor functional
results of varicocele surgery, Dr. Parag
Shah put forth his theory of 'Cremasteric
Compartment Complex'. Surgery of cremasteric
disruption with venous ligation based on the above theory gives
excellent functional results.
Numerous theories have been suggested
Pooling of warm venous blood leads to impaired spermatigenesis
Increased concentration of metabolic waste products (Nitric oxide
/ reactive oxygen free radicals). Abnormal concentration of adrenal
and renal substances.
Decreased availability of oxygen and nutrients.
Impairment of testosterone production and concentration.
smoking in presence of varicocele has a greatly adverse effect.
Varicocele indisputably is a significant factor in decreasing testicular
function and deterioration of semen quality.
causes progressive duration-dependent injury of the seminiferous
epithelium and testicular function.