All of the following are true about varicocele, EXCEPT:

Varicocele is due to abnormal dilation of spermatic cord veins, also known as the pampiniform plexus, due to faulty valvular venous return. Most varicoceles occur on the left, possibly due in pa to the acute angle of confluence with the left renal vein and resulting higher IV pressure. Classically, the mass of enlarged veins can be palpated superior and posterior to the testis ("bag of worms"), and is more prominent when standing or with Valsalva maneuver. The sudden onset of a right varicocele should raise the question of a retroperitoneal malignancy resulting in obstruction of the right spermatic vein. Varicocele may lead to infeility in some men. Ref: Cooper C.S., Joudi F.N., Williams R.D. (2010). Chapter 38. Urology. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.