Bähren classification of left varicoceles

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Bähren classification of left varicoceles:

  • type 0: no evidence of venous reflux in internal spermatic vein (ISV)
  • type I: single ISV with insufficient or absent valve
  • type II: single ISV with ≥ 2 ostia to renal vein; may be branches to ascending lumbar/retroperitoneal veins
    • IIa: insufficient confluence valve function
    • IIb: sufficient confluence valve function
  • type III: single incompetent ISV at renal vein junction, with caudal duplication
  • type IV: valveless collaterals between ISV and segmental renal/retroperitoneal veins
    • IVa: insufficient confluence valve
    • IVb: sufficient confluence valve function
  • type V: IVC or renal vein anomaly; ISV may enter IVC/renal/ascending lumbar veins

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