Under what condition is surgery indicated for a varicocele?

Surgery is indicated for a varicocele primarily when there is a decrease in testicular volume due to hypotrophy. Hypotrophy, or underdevelopment of the testicle, can occur as a result of impaired blood flow and oxygenation due to the presence of a varicocele. The abnormal venous drainage can lead to increased pressure and subsequent testicular injury or atrophy over time.

Addressing the condition surgically can help restore adequate blood flow, improve testicular health, and potentially restore normal testicular size. Surgical intervention is particularly vital in adolescents or young men, where the preservation of normal testicular function and size is crucial for fertility and hormonal balance.

While painful masses on the testis, recurrent urinary tract infections, or testicular cancer may present with related symptoms or concerns, they represent different clinical indications. Pain alone and recurrent urinary tract infections are generally managed through other interventions or conservative measures unless they lead to specific concerns of testicular health. The presence of evidence of testicular cancer would necessitate a different surgical approach focused on the oncology aspect rather than addressing a varicocele specifically.