This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urology, Subject name: Anatomy
[{'content': 'Not true about varicocele is \nSelect and explain. \nA. Commmon on the right side, B. Can present as a late sign of renal cell carcinoma, C. Has a bag of worms like feeling, D. Can lead to infeility', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Varicocele is seen on left side in 95% of cases Varicocele It is seen 95% of times on left side. Several anatomic features contribute to the predominance of left-sided varicoceles. The left internal spermatic vein is longer than the right; in addition, it usually joins the left renal vein at right angles. The right internal spermatic vein has a more oblique inseion into the inferior vena cava. This paicular anatomy in the standing man may cause higher venous pressures to be transmitted to the left scrotal veins and result in retrograde reflux of blood into the pampiniform plexus. Clinical picture Age - young adult Tall thin men are frequently affected* Bag of worms* like feel on palpation The veins empty in supine position (so examination is always done in standing position) Infeility: The varicocele is the most common cause of male infeility worldwide. In approximately 70% of patients with secondary infeility, a varicocele is an underlying cause. "The World Health Organization concluded that varicoceles are clearly associated with impairment of testicular function and infeility." Varicocele may be secondary to renal cell carcinoma of the left kidney. The growth from renal cell carcinoma blocks the renal vein by venous permeation. So sudden onset of varicocele (left side) in middle-aged man should arouse suspicion of a renal cell carcinoma of the left side.', 'role': 'assistant'}]