Why is a varicocele far more common on the left side than the right?

• A The left internal spermatic vein drains directly into the inferior vena cava
• B Valves are congenitally absent only in the right spermatic vein
• C The left testis receives its arterial supply from the renal artery
• D The left internal spermatic vein enters the left renal vein at a right angle beneath the superior mesenteric artery ✓

Explanation

The left internal spermatic vein drains into the left renal vein at a right angle, and between the superior mesenteric artery and aorta it may be compressed, producing the nutcracker effect with raised venous pressure and varicosity. The right vein drains obliquely and directly into the inferior vena cava, so pressure transmission is less. Option A reverses this anatomy. Arterial supply is from the aorta bilaterally, and valve incompetence occurs more often on the left, not the right.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.