Patient selection: unilateral varicocele
Clinical findings:
(1)
The male has evidence of unilateral varicocele.
(2) The varicocele may be associated with scrotal pain.
(3) The patient is often over 40 years of age.
(4) The varicocele does not disappear if the patient lies down.
(5) Imaging shows the presence of a retroperitoneal tumor.
Retroperitoneal tumors may include:
(1) renal cell carcinoma
(2) adrenocortical carcinoma
(3) pheochromocytoma or paraganglioma
(4) liposarcoma
Mechanism:
(1) intravascular tumor growth obstructing return through the testicular vein
(2) venous compression of the testicular vein or inferior vena cava
