Bag of worm feel is seen in:

Ans: b (Varicocele) Ref: Bailey, 24th ed, p. 1407Bag of worm feel on palpation is characteristically seen in varicocele.Varicocele* Condition in which veins of the pampiniform plexus becomes dilated and tortuous.* Usually left side is affected.* Impulse on coughing is more like a thrill.* On palpation it feels like a 'bag of worms'.* Rapid onset varicocele suggests a carcinoma of kidney.( Renal vein is often involved earlier by penneation and thus compress left spermatic vein which drain into left renal vein and on right side I.V.C is affected into which drains right spermatic vein)* Oligospermia -->>it interferes with the normal temperature control of scrotum and affects spermatogenesis (evidence for this is contradictory)Why left side common?* Left spermatic vein is longer than right.* Left spermatic vein enters the left renal vein at a right angle.* At times left testicular artery arches over left renal vein and compresses it.* Left colon when loaded may press on the left testicular vein.TreatmentTreatment of choice - Embolisation of the testicular vein under radiographic control.Varicocele is a common condition that tends to recur after surgical treatment.