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

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. 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. 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). 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.