Association between varicocele and hemorrhoidal disease in men presenting with groin pain: a retrospective comparative study.

OBJECTIVE: To evaluate the independent association between varicocele and hemorrhoidal disease in men presenting with groin pain. This study considers varicocele not merely as a localized scrotal condition, but as a potential manifestation of systemic venous insufficiency, sharing common pathophysiological mechanisms with hemorrhoidal disease, such as venous dilation and elevated pressure. MATERIALS AND METHODS: Between January 2023 and September 2025, 292 men presenting with groin pain were assessed, and 186 met the inclusion criteria. Group 1 consisted of 81 men with varicocele who underwent varicocelectomy, and Group 2 included 105 men without varicocele (controls). Beyond univariate comparisons, a multivariable logistic regression model was utilized to identify independent predictors and adjust for potential confounders, including constipation. Model stability and calibration were verified using the Hosmer-Lemeshow test and Variance Inflation Factor (VIF) analysis. RESULTS: There were no significant differences between groups regarding age, height, weight, body mass index, or smoking status (p > 0.05). Hemorrhoidal disease was significantly more frequent in the varicocele group than in controls (43.2% vs. 18.0%, p = 0.016). Multivariable logistic regression revealed that hemorrhoidal disease is a strong independent predictor of varicocele presence (Adjusted OR: 3.27; 95% CI: 1.66–6.59; p < 0.001). Additionally, constipation was identified as a significant independent predictor (Adjusted OR: 8.39; 95% CI: 2.61–37.64; p = 0.001). The model demonstrated high reliability with no multicollinearity (VIF = 1.00) and an acceptable goodness-of-fit (p = 0.054). CONCLUSION: Hemorrhoidal disease and constipation are independently associated with varicocele, consistent with a potential link through systemic venous insufficiency. Recognizing this association may facilitate a more comprehensive clinical evaluation of patients presenting with these interconnected venous conditions.