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What expands in size due to the build-up of pooled blood in a varicocele?

  1. Testicles

  2. Scrotum

  3. Veins within the scrotum

  4. Urethra

The correct answer is: Veins within the scrotum

In cases of a varicocele, it is the veins within the scrotum that expand in size due to the pooling of blood. A varicocele involves the enlargement of the pampiniform plexus, which is a network of veins that is responsible for draining blood from the testicles. When the valves within these veins become incompetent or are damaged, blood can accumulate, leading to increased pressure and varicosity. This engorgement causes the veins to dilate, giving the characteristic "bag of worms" appearance upon examination. The testicles themselves do not expand unless there is associated pathology, such as testicular hydrocele or another condition. The scrotum may appear swollen due to the abnormal enlargement of the veins, but it is the veins that are primarily affected in terms of changes in size. The urethra is not affected by a varicocele, as it serves a different function entirely and is not related to the vascular changes occurring in the scrotal area. In summary, the primary focus of a varicocele is the engorgement of the veins, which are responsible for the condition, making the expansion of the veins within the scrotum the most accurate answer to the question posed.