Varicoceles are a common finding in the general public. The incidence appears to increase later in life with a contemporary study finding an increase in incidence of 10% per decade of life. [1] While common in the general population, they are even more common among those presenting for a fertility evaluation, as high as 39% in some series and are often initially diagnosed during such examinations. [2] Others present without symptoms or fertility issues and are found incidentally on a physical exam by a general practitioner. Care for the asymptomatic varicocele is controversial, especially in those, in which the testicles are equally sized. While there has been a considerable amount of research about the progression of such varicoceles in adolescent boys, there is much less knowledge about asymptomatic varicoceles in the postpubertal male. In patients who are symptomatic with either fertility issues or varicocele related pain, there are clear indications for varicocele repair. [3] The question for asymptomatic patients is whether a varicocele causes any problems other than infertility or pain and whether untreated varicoceles will inevitably lead to the development of such issues, especially after puberty.

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