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Varicocele is a dilation (enlargement) of the internal spermatic veins that drain the testicle (picture below). It is a similar condition to varicose veins that people get in their legs. It is a very common condition present in 15% of the general male population and 40% of men evaluated for infertility. A varicocele develops because of defective valves that normally allow for blood to flow back from the testicle to the abdomen. When the one-way valves don’t trap the blood, gravity is pulls the blood down to the testicle. Testicular injury occurs due to abnormal back flow of blood from the abdomen into the scrotum and this creates an inhospitable environment for sperm development. The significance of this condition has been known for a thousand years. The first century Greek physician Celcius originally described the varicocele: “The veins are swollen and twisted over the testicle, which becomes smaller than its fellow in as much as its nutrition has become defective”.
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