Objective: To test the classic teaching that isolated right varicoceles are associated with significantly high rates of occult malignancies.
Methods: Retrospective chart review included all men diagnosed with varicocele at the Cleveland Clinic from 2000 to 2015. Charts were queried for demographics, varicocele laterality, cross-sectional imaging, and subsequent diagnosis of abdominal malignancy or vascular anomaly. Descriptive statistics are presented as means ± standard deviation. Comparative statistics include analyses of variance with Tukey-Kramer pairwise comparisons or chi-square tests as indicated. All P <.05 are considered significant.
Results: Varicocele was diagnosed in 4060 men (3258 left, 337 right, and 465 bilateral). Men with right varicoceles were significantly older (43.6 ± 17.1) than left (33.4 ± 14.9, P <.0001) or bilateral (34.9 ± 15.3, P <.0001), and had higher body mass indices (right 28.9 ± 5.7; left 26.4 ± 5.5, P <.0001 and; bilateral 26.5 ± 5.5, P <.0001). Laterality of varicocele was not significantly associated with cancer diagnosis (P = .313), with cancer diagnosed in 2.67% of right, 1.63% of left, and 2.15% of bilateral varicoceles. Rates of abdominal computed tomography imaging differed significantly (P <.0001) by laterality: 30.3% of right, 8.7% of left, and 11.2% of bilateral varicoceles were scanned. Vascular anomalies did not significantly differ by varicocele laterality.
Conclusion: Men with right varicoceles were older, heavier, and underwent more computed tomography scans than those with left or bilateral varicoceles but did not have higher rates of cancer diagnosis.
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