Varicocele: historical background, anatomical features, and prerequisites for development

Varicocele, an abnormal enlargement of the pampiniform venous plexus in the scrotum. This paper provides an overview of important information on the historical aspects, anatomical structure of the testicular vascular system, and hemodynamic prerequisites for the development of varicocele. The aim of this study is to analyze scientific papers focused on the anatomical and etiopathogenetic features of varicocele. Materials and methods. This paper is a literature review (PubMed, Scopus, Embase) describing the history of varicocele investigation, anatomical features of the testicular venous system, and the hemodynamic prerequisites of the pathology. Results. In elective pediatric surgery, varicocele is one of the most common pathologies among boys over the age of 10, with a prevalence of 14–20 %. However, the pathophysiology of varicocele and the optimal treatment approach remain subjects of ongoing debate. Nonetheless, all research on the origins and treatment of varicocele contributes to a growing knowledge base. The authors, relying on scientific studies, anatomical knowledge, and surgical experience, describe the historical background of the disease, the anatomical prerequisites, and the causes of varicocele development in children. The paper highlights the anatomical features of testicular blood supply and the hemodynamic conditions for the development of varicocele, which partially elucidate the disease’s etiopathogenesis and serve as a step toward optimizing the choice of surgical treatment method. Conclusions. Varicocele as a pathology has been known since ancient times, and approaches to its treatment have evolved over the centuries. Disruptions in the embryogenesis of the venous system, venous valve insufficiency, and arteriovenous conflicts are key factors in the development of varicocele. Understanding these anatomical features is crucial for selecting the appropriate surgical approach and improving treatment effectiveness.