A varicocele is an abnormal dilation of the pampiniform venous plexus, a network of veins that drains the testicle. It is often described as feeling like a “bag of worms” on physical examination and occurs much more commonly on the left side due to the anatomy of the left testicular vein. Varicoceles are a significant cause of male infertility, as the pooling of warm blood around the testicle can impair sperm production. On ultrasound, a varicocele is identified as multiple dilated, tortuous veins (greater than 2 to 3 millimeters in diameter) adjacent to the testis, and characteristically, these veins increase in size and show reflux (reversed flow) during the Valsalva maneuver (bearing down). Color Doppler confirms the diagnosis by demonstrating the retrograde flow during Valsalva.
Sonography Term