Varicocoele — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 79 of 2019

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting varicocoele or death from varicocoele with the circumstances of a person's relevant service:

1. (1)
   having an occlusion or stenosis of the testicular venous drainage system before the clinical onset of varicocoele; (a) inferior vena cava; (b) internal iliac vein; (c) left or right renal vein; (d) lumbar vein; (e) pampiniform plexus; and (f) testicular vein. Rare anatomical variants may exist where the testicular vein and its tributaries empty into blood vessels which are not commonly part of the testicular venous drainage system;

   Note: Blood vessels of the testicular venous drainage system may include, but are not limited to:.

   Note: occlusion or stenosis is defined in the Schedule 1 - Dictionary.

2. (2)
   having a nephrectomy within the one year before the clinical onset of the ipsilateral varicocoele;
3. (3)
   having an arterio-venous fistula between any of the arteries supplying the testis and a vein of the pampiniform plexus at the time of the clinical onset of varicocoele;

   Note: arteries supplying the testis is defined in the Schedule 1 - Dictionary.

4. (4)
   having ankylosing spondylitis at the time of the clinical onset of varicocoele;
5. (5)
   having Behcet disease at the time of the clinical onset of varicocoele;
6. (6)
   having an occlusion or stenosis of the testicular venous drainage system before the clinical worsening of varicocoele; (a) inferior vena cava; (b) internal iliac vein; (c) left or right renal vein; (d) lumbar vein; (e) pampiniform plexus; and (f) testicular vein. Rare anatomical variants may exist where the testicular vein and its tributaries empty into blood vessels which are not commonly part of the testicular venous drainage system;

   Note: Blood vessels of the testicular venous drainage system may include, but are not limited to:.

   Note: occlusion or stenosis is defined in the Schedule 1 - Dictionary.

7. (7)
   having a nephrectomy within the one year before the clinical worsening of the ipsilateral varicocoele;
8. (8)
   having an arterio-venous fistula between any of the arteries supplying the testis and a vein of the pampiniform plexus at the time of the clinical worsening of varicocoele;

   Note: arteries supplying the testis is defined in the Schedule 1 - Dictionary.

9. (9)
   having ankylosing spondylitis at the time of the clinical worsening of varicocoele;
10. (10)
    having Behcet disease at the time of the clinical worsening of varicocoele;
11. (11)
    undertaking physical activity at a minimum intensity of six METs, for at least six hours per week for at least the four weeks before the clinical worsening of varicocoele;

    Note: MET is defined in the Schedule 1 - Dictionary.

12. (12)
    for rupture of varicocoele only: (a) having sexual intercourse at the time of the clinical worsening of varicocoele; or (b) having increased intra-abdominal pressure as specified, which has resulted in a scrotal or spermatic cord haematoma, within the seven days before the clinical worsening of varicocoele;

    Note: increased intra-abdominal pressure as specified is defined in the Schedule 1 - Dictionary.

13. (13)
    inability to obtain appropriate clinical management for varicocoele;

Aggravation-only factors: the factors in subsections 9(6) to 9(13) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.