A 22-year-old man with a left grade III varicocele and scrotal dull ache undergoes percutaneous embolization. Via the right femoral vein, the catheter is advanced to the gonadal vein. On the left side, the incompetent vein that is catheterized and embolized is the:

• A Left internal iliac vein
• B Left testicular (internal spermatic) vein ✓
• C Left renal vein
• D Left inferior phrenic vein

Explanation

Varicocele results from reflux in the internal spermatic (testicular) vein, which on the left drains at a right angle into the left renal vein, explaining the far higher incidence on the left. Embolization uses coils, often combined with a sclerosant, delivered into the left testicular vein to abolish reflux while preserving lymphatics and arterial supply. The left renal vein is the receiving vessel and is not embolized, and the right testicular vein drains directly into the IVC.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.