The role of the spermatic cord layers in the development of varicoceles

The theory that insufficiency of the spermatic cord layers could be the etiological factor in the development of varicocele is reviewed critically. A prospective study of 40 patients operated upon for a left indirect inguinal hernia was done. The spermatic cord layers were excised as a routine part of the operation but combined manual and Doppler examinations revealed no postoperative reflux into the pampiniform plexus. We conclude that the spermatic cord layers probably do not have a major role in the pathogenesis of varicocele.