Epidemiology

Anecdotally, it has been estimated that between 10% and 15% of men and adolescent boys in the general population have varicocele.[3] In the US, the overall incidence of adolescent varicocele is 15%, which is similar to that of the adult population.[4] Globally, incidences may vary; a slightly lower incidence was reported in a prospective study from Bulgaria.[5] However, the true incidence of adolescent varicoceles may be under-reported, as most teens are not routinely examined in the upright position.

The majority (>80%) of adult varicoceles are not associated with infertility.[6][7]​ However, the prevalence of varicocele is greater in patients with subfertility. Approximately 1 of 4 men with abnormal semen parameters will have a varicocele, and 40% of men presenting with infertility have a varicocele.[8] Furthermore, up to 80% of men with secondary infertility have a varicocele.[9]

Pre-pubertal varicoceles are very rare, suggesting that puberty may be one initiating factor.[10] Ninety percent of varicoceles are on the left side, while approximately 10% are bilateral. An isolated right-sided varicocele is rare.

Varicoceles appear to be more common in males who are tall and lean, with a lower BMI than age-matched controls.[11][12][13]​ One meta-analysis reported that underweight patients had a higher risk of varicocele, while patients with a BMI greater than or equal to 25 had a lower risk.[14] There is an increased incidence of varicocele in first-degree relatives, particularly brothers of affected males, suggesting a potential genetic basis, and also a role for screening.[15][16][17]

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