A POSSIBLE ONTOGENIC ETIOLOGY FOR IDIOPATHIC LEFT VARICOCELE

A total of 659 consecutive patients underwent venography for the evalu ation of idiopathic left varicocele before sclerotherapy. In 484 cases no valves of the left spermatic vein could be demonstrated, while 172 patients demonstrated competent valves or absent insertions of the le ft spermatic vein at the typical point on the left renal vein plus ret rograde flow over persistent intercardinal anastomoses. Stenosis of th e renal vein occurred in 103 patients (15.7%). In only 3 patients was stenosis observed in the course of the left iliac vein, suggestive of the so-called distal nutcracker phenomenon. We propose that during emb ryogenesis disturbances in the development of the secondary venous sys tem may result in the idiopathic left varicocele.