Regional distribution of intratesticular varicoceles accompanying extratesticular varicocele cases.

Abstract

Objective: Only few cases of intratesticular varicocele (ITV) have been reported in the literature, mostly as single cases or a case series. In this study, we aimed to describe the topographic distribution of ITVs in the testicular parenchyma and the correlation between ITV accompanying extratesticular varicocele (ETV) and age.

Methods: Approximately 10,537 patients with scrotal pain and swelling who visited our hospital between August 2014 and May 2020 and underwent scrotal colour Doppler ultrasonography were included in this study. Of these patients, 2285 had ETV, and the remaining patients (n=8252) had other testicular pathologies such as acute-chronic torsion, testicular mass, orchitis, significant testicular atrophy, or isolated extratesticular varicocele, and were thus excluded from the study. Among the 2285 patients, only 20 had ITV.

Results: Of the 20 patients with ITV, 2 had isolated ITV, and the remaining had ITV accompanying ETV, of whom only one had a right ETV. One patient had left testicular atrophy accompanying an isolated ITV. Among the ITV cases, subcapsular ITV was the most common (n=13), followed by central ITV (n=4) and subcapsular and hilar ITV (n=3). The patients' ages ranged from 18 to 30 years.

Conclusion: ITV is a rare clinical entity that occurs only in young men, with most cases accompanying ETV. ITV is generally peripherally located in the testicular parenchyma. In this study, no correlations were found between ITV, ETV, and age. As in this study, testicular atrophy is rarely observed in patients with ITV. No studies have presented ITV cases with spermiogram analysis results. Thus, the effect of ITV on male reproductive fertility is still unknown, and further study on this topic is needed.