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Phleboliths in varicoceles presenting as spermatic cord mass.

Lazarou S, Reyes-Vallejo L, Morgentaler A

Harvard Medical School, Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. s_lazarou@yahoo.com

OBJECTIVE: To discuss the diagnosis and management of phleboliths in the dilated veins of a varicocele. DESIGN: Case report. SETTING: Two healthy patients in an academic andrology center. PATIENT(S): Two healthy patients undergoing evaluation and treatment of male factor infertility. INTERVENTION(S): Ultrasonography and varicocele repair. MAIN OUTCOME MEASURE(S): Improvement in male factor infertility. RESULT(S): One patient had a phlebolith diagnosed ultrasonographically by echogenicity and acoustic shadowing within a dilated vein of a varicocele. Another patient had a hard mass found within a dilated vein of a varicocele at the time of surgical repair. CONCLUSION(S): A hard rounded mass within a spermatic vein identified at surgery or sonographically within the veins of the spermatic cord should be considered a phlebolith. Decisions regarding treatment depend on clinical presentation.

Published 4 July 2006 in Fertil Steril, 86(1): 219.e21-2.
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