A 25-year-old man presents with a dull scrotal ache worse on standing, described as feeling like a bag of worms. The swelling is larger on the left and reduces on lying down. Which anatomical feature explains the left-sided predominance?
- A The left testicular vein drains into the inferior vena cava at an acute angle
- B The left testicular vein drains into the left renal vein at a right angle ✓
- C The left testis hangs lower due to a longer left spermatic cord only
- D The right testicular artery compresses the right testicular vein
Correct answer: B. The left testicular vein drains into the left renal vein at a right angle
Explanation
The left testicular vein enters the left renal vein almost at a right angle while the right testicular vein drains obliquely directly into the inferior vena cava. The longer vertical column and perpendicular entry raise hydrostatic pressure on the left, dilating the pampiniform plexus. Option A states the reverse of the true arrangement, making it the best distractor to kill.
Reference: Snell's Clinical Anatomy by Regions, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.