Varicocele: Difference between revisions

Line 46:

=== History and Physical Exam ===

* '''Physical Exam'''

** '''Examine the patient in both the supine and standing positions, with and without Valsalva.''' '''The veins should decompress in the supine position'''

** '''Genitals'''

***Failure to do so, particularly on the right side, may be from an abdominal or pelvic mass.

***'''Scrotum'''

** '''Testicular ~~consistency~~''' ~~should be assessed~~; ~~the~~ affected testis may be soft.

****'''Examine the patient in both the supine and standing positions, with and without Valsalva.''' '''The veins should decompress in the supine position'''

** '''~~Measurement of testicular volume~~''' ~~is important because it~~ may predicate surgical intervention

*****Failure to do so, particularly on the right side, may be from an abdominal or pelvic mass.

**** '''Testicular'''

*****'''Consistency'''; affected testis may be soft

***** '''Volume;''' may predicate surgical intervention

=== Imaging ===

*'''Abdominal/pelvic CT or US'''

**'''~~Routine imaging based solely on the presence of~~ a ~~right~~ varicocele is ~~unnecessary.~~[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''

**'''Indications'''

**'''~~Abdominal~~ imaging ~~should be considered for men with~~ a ~~new onset or non-reducible varicocele, especially if~~ varicocele is ~~large~~[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''

***'''Consider for males''' '''with a new onset or non-reducible varicocele, especially if varicocele is large[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''

***'''Routine imaging based solely on the presence of a right varicocele is unnecessary.[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''

== Management ==

@@ Line 46: / Line 46: @@
 === History and Physical Exam ===
 * '''<span style="color:#ff0000">Physical Exam'''
-** '''<span style="color:#ff0000">Examine the patient in both the supine and standing positions, with and without Valsalva.''' '''The veins should decompress in the supine position'''
+** '''<span style="color:#ff0000">Genitals'''
-***Failure to do so, particularly on the right side, may be from an abdominal or pelvic mass.
+***'''<span style="color:#ff0000">Scrotum'''
-** '''Testicular consistency''' should be assessed; the affected testis may be soft.
+****'''<span style="color:#ff0000">Examine the patient in both the supine and standing positions, with and without Valsalva.''' '''The veins should decompress in the supine position'''
-** '''Measurement of testicular volume''' is important because it may predicate surgical intervention
+*****Failure to do so, particularly on the right side, may be from an abdominal or pelvic mass.
+**** '''Testicular'''
+*****'''Consistency'''; affected testis may be soft
+***** '''Volume;''' may predicate surgical intervention
 === Imaging ===
 *'''Abdominal/pelvic CT or US'''
-**'''Routine imaging based solely on the presence of a right varicocele is unnecessary.[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''
+**'''Indications'''
-**'''Abdominal imaging should be considered for men with a new onset or non-reducible varicocele, especially if varicocele is large[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''
+***'''Consider for males''' '''with a new onset or non-reducible varicocele, especially if varicocele is large[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''
+***'''Routine imaging based solely on the presence of a right varicocele is unnecessary.[https://pubmed.ncbi.nlm.nih.gov/33295257/ ★]'''
 == Management ==