Association between Lumbar, Renal, and Gonadal Vein Diameters and Varicocele in People with Left-Sided Nephrectomy: An Observational Study

Introduction: Varicocele, which is defined as varicose veins in the scrotum, is associated with different complications, in particular infertility. However, the definite etiologies have not determined yet. Our objective was to investigate the association between left lumbar, renal, and gonadal veins diameters and varicocele occurrence and grading in kidney donors underwent left-sided nephrectomy. Also, the frequency of varicocele were evaluated three months after the surgery.Methods: In this observational study, male kidney donors aged 18 to 65, who underwent open nephrectomy were included between 2022 and 2023. Baseline data on age, body mass index (BMI), and the presence or grade of varicocele were collected through medical records and physical examinations. During the procedure, the diameter of the left lumbar, renal, and gonadal veins was measured using a graded ruler on the back table. Three months after the nephrectomy, the patients were re-evaluated for varicocele recurrence. Results: We included 30 kidney donor with a mean age of 38.2 years and BMI of 23.5 kg/m2. The renal vein diameter decreased with higher grading (p=0.05) and the gonadal vein diameter increased with higher grading (p=0.04). However, there was no significant association between varicocele grading and left lumbar vein diameter. Following three months of nephrectomy, the frequency of varicocele increased from 33.4% to 50.0%. Conclusion: The diameter of the left lumbar vein was almost unchanged in varicocele, while the size of the left renal vein decreased, and the size of the left gonadal vein increased. Furthermore, occurrence of varicocele increased after three months of left-sided nephrectomy. Therefore, people undergoing nephrectomy are at a higher risk of developing varicocele which should be considered in follow-up visits.