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Online ISSN 1827-1766
Gioffrè L. 1, Bosco M. R. 1, Meloni V. 1, Vietri F. 1, Menchini Fabris G. F. 2
1 Cattedra di Chirurgia Generale, Dipartimento di Scienze Chirurgiche e Tecnologie Mediche Applicate, Università degli Studi “La Sapienza”, Roma;
2 Unità Operativa Autonoma di Andrologia, Dipartimento di Medicina della Procreazione e dell’Età Evolutiva, Università degli Studi di Pisa, Pisa
The aim of this work was to clearly illustrate that the haemodynamic pathogenesis of the varicocele can be a consequence of a retrograde flux along the internal spermatic vein. The reflux is due to the use of a different path of flow along the internal spermatic vein which uses some collateral routes of the vessel, and mainly the nephrogenital branch. The diminishing pressure in the final segment of the internal spermatic vein is the focal point of the pathogenesis of the disease. The ontogenetic process leading to the formation of the left renal vein help that lead in explaining the almost general one-sidedness of the disorder, its frequency and the fact that it is mostly the young who are affected by it. In fact, the variability of the timing and of the extension of the involution of the primitive venous system and of the processes of evolution which lead to the morphological definition of the tracts of the genital flow down, lead to the various manifestations of the idiopathic varicocele. This theory which also takes into account the physiological mechanism of the venous drainage of the testicle in an anti-gravitation sense is part of the patterns that, under the diaphragm, rule the entire venous return of the blood toward to the heart.