Internal spermatic venography in patients with bilateral varicocele

Internal spermatic venography was performed during surgery on 15 patients with bilateral varicocele to investigate the influx route of the spermatic vein, especially on the right side. All 15 left internal spermatic veins flowed into the left renal vein without exception. Although 4 of them (27%) flowed smoothly into the inferior vena cava through the renal vein, there were some disturbances of venous return in 11 cases; stagnation of the blood stream at the renal vein or backward flow into the intrarenal vein. On right internal spermatic venography, 10 spermatic veins (67%) flowed directly into the inferior vena cava while 5 flowed into the right renal vein. All of those 5 cases had a disturbance in venous return from the renal vein to the inferior vena cava. However, none of them showed any connection between the right and left spermatic veins.