Varicoceles: the diagnostic dilemma.

Clinical examination of the scrotum remains the most commonly used technique to diagnose varicoceles. However, scrotal anatomy (eg, thick scrotum, scarring, hydrocele) in some men may make physical examination alone unreliable. In these situations, imaging (eg, ultrasound, Doppler imaging, venography) may be used to diagnose a varicocele. The dilemma is that there are no widely accepted or used criteria to diagnose a varicocele based on imaging. This paper reviews the different imaging techniques used and the accuracy of each in diagnosing a varicocele.