In Reply to: Case 0400_09 -- Pelvic Congestion Syndrome:The Diagnostic Value of Venography posted by Editor on April 04, 2000 at 16:55:39:
The male counterpart (varicocele) is often diagnosed simply from physical exam with confirmatory ultrasound of the externally symptomatic part. Semen analysis may play a role as well. Getting a CT is not routine in those patients although if an isolated right sided varicocele is present, a CT is a good idea to exclude compression from adenopathy, tumor, etc. In females, the history is very important as Doppler, physical exam, and (obviously) semen analysis is not as useful or possible. If there is any question about the accuracy of the diagnosis or a secondary cause is suspected, CT would be the next choice followed by venography, especially if the CT was normal.