Is there a co-association between renal or retroperitoneal tumours and scrotal varicoceles? A systematic review

James Robson, Stephen Wolstenhulme, Peter Knapp

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Scrotal varicoceles, which are relatively common, are sometimes caused by venous flow disturbance resulting from a renal or retroperitoneal tumour. Consequently, it is common practice to perform extended renal and retroperitoneal scans following varicocele identification. The aim of this systematic review was to determine the extent of the co-association between renal or retroperitoneal tumours and scrotal varicoceles using primary research literature. We conducted a search of 11 electronic databases; hand-searched five relevant textbooks; and conducted forward- and backward-citation searches of included articles. Articles that were included were assessed for research quality and data extracted. Twenty-four articles were found,
comprising 19 case reports and five case series, reporting 35 cases in total. All cases had both a varicocele and a tumour (renal, retroperitoneal or other). We found no cohort or case–control studies. In conclusion, case reports and case series are susceptible to significant publication bias and the lack of any cohort or case–control studies meant that it was not possible to establish the extent of the co-association between renal or retroperitoneal tumours and scrotal varicoceles. It was not possible to estimate the value of conducting an extended scan in patients with scrotal varicoceles. Research is needed, particularly of a cohort or case-control design and including a robust sampling method, to examine the extent of any co-association. Meanwhile, extended renal or retroperitoneal scans should be undertaken when diagnosing all varicoceles, regardless of patient age, until this research is completed.
Original languageEnglish
Pages (from-to)182-191
Number of pages10
Issue number4
Publication statusPublished - Nov 2012

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