Introduction: We evaluated a possible effect of the amount of retroperitoneal fat tissue on testicular venous drainage to shed light on the mechanism of varicocele occurrence. Patients andMethods: A total of 132 patients with no fertility complaints were included in this study. Retroperitoneal fat thickness (RPFT) was measured during abdominal computed tomography examinations. According to the calculated body mass index (BMI), patients were categorized as normal, overweight or obese using National Institutes of Health criteria. Relationships were sought between RPFT, BMI and testicular vein-pampiniform plexus diameters measured with ultrasonography on both sides. Results: Left and right testicular vein maximum diameters were significantly larger in obese patients compared with normal and overweight men (p = 0.01 and p = 0.003, respectively). In accordance with this, the left and right pampiniform plexus diameters were larger in the obese group than in the normal and overweight groups (p = 0.004 and p = 0.006, respectively). There was a moderate but significant correlation between the right testicular vein maximum diameter and mean RPFT (p = 0.003). The relationship between bilateral pampiniform plexus diameters and retroperitoneal fat distribution was stronger and significant (p = 0.0001). Correlation analysis revealed a significant relationship between BMI and retroperitoneal fat distribution (R = 0.53, p = 0.0001). Conclusions: The amount of retroperitoneal fat, which is related to BMI, could be a contributing factor in the etiology of right varicocele.

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