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Varicocele may be defined as diffuse dilation of the pampiniform plexus (the venous drainage of the scrotum). Generally, the venous drainage of the scrotum begins with multiple scrotal veins that coalesce with the plexus. This drainage ascends along the cord structure and ultimately forms a single testicular vein, draining on the right into the vena cava and on the left renal vein. Although the main symptom of admission is dilated veins observed in the scrotum, patients with especially high-grade varicocele suffer from chronic groin pain. This may limit the physical performance.
The etiology remains unclear. Most theories have as a common thread an increased venous backpressure with sub-sequent venous varicosity. These theories are based on insufficient venous values anatomic angle of venous drainage, external compression of the drainage system and backflow of metabolites from left adrenal vein onto the subjacent testis. Although varicocele can appear at any pediatric age, the incidence peaks near mid-puberty and catches the incidence of adult population. Overall, varicocele are estimated to occur in 15% of the adolescent population. They are almost all left-sided and rarely bilateral. Right-sided varicocele has been reported with situs inversus, adding to the emphasis on anatomic etilogy. Most adolescents who have varicocele are asymptomatic and discovered on routine examination. There may be some mild discomfort. Although the mechanism is unclear, there is general agreement that larger varicoceles are more likely to result in testicular injury than smaller ones, and that this injury appears to be a function of increasing time.
Most cases of childhood varicocele require no treatment, but because of the gross apperance of varicocele, parents need to be well counseled. Generally, a larger scrotum than normal is observed during physical examination when the boy stands upright. Palpation of the scrotum is like feeling “a bag of worms”. The mass of veins often disappear when the child lies down. Adolescents who have pain, large varicoceles, or loss of ipsilateral testicular volume over time should undergo surgical therapy. Prior surgical therapies focusing on mass ligation of the internal spermatic vessels have had good results, but a significant incidence of postoperative hydrocele is reported.

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Adolescents who have loss of iplsilateral testicular volume over time should undergo-

The Correct Option is D

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The venous drainage of the scrotum ultimately forms -

The Correct Option is A

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Varicocele patients of which grade suffer from chronic groin pain ?

The Correct Option is D

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Why do parents need to be well counseled in the case of childhood varicocele ?

The Correct Option is C

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Which of the following Adolescent population is safe from varicoceles ?

The Correct Option is A

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