The Relationship Between Varicocele and Lower Extremity Chronic Venous Insufficiency: A Population-Based Case-Control Study

Background: This study explores the potential relationship between varicocele and varicose veins, focusing on their shared pathophysiological mechanisms and clinical implications, and includes an additional subgroup analysis across age groups.Varicocele is a major cause of male infertility, affecting 15-20% of men in the general population and up to 30-40% of infertile men.Varicose veins, caused by venous valve dysfunction, are more prevalent in older individuals.Despite their structural and functional similarities, the possible link between these two venous disorders has not been adequately investigated. Materials and Methods:A retrospective, population-based case-control study was conducted in a province in Trkiye using the Ministry of Health Public Hospitals Research Database.A total of 1,279 patients with varicose veins and 5,091 age-and sex-matched controls (1:4 ratio) were included.Diagnoses were identified using ICD-10-CM codes, and diagnostic validity was ensured by requiring at least two separate clinical entries for the same diagnosis.Conditional logistic regression was used to evaluate the association between varicose veins and varicocele, adjusting for confounders including age, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, liver disease, and kidney disease.The lack of Doppler ultrasonographic confirmation and absence of varicocele grading data were acknowledged as limitations of the retrospective design. Results:The prevalence of varicocele was 1.3% in cases and 0.3% in controls (p < 0.001).Logistic regression analysis revealed an odds ratio of 2.41 (95% confidence interval: 1.80-4.92)for the association between varicocele and a history of varicose veins, and the association was more pronounced among younger patients. Conclusion:This study demonstrates a significant association between varicocele and varicose veins, particularly in individuals under 50 years of age.These findings suggest shared pathophysiological mechanisms and warrant further investigation into the underlying venous dysfunction that links these conditions.