Figure 1: A 45-year-old American Caucasian man with erectile dysfunction, ventral curvature, varicocele and testicular ptosis. A). Bilateral varicocele (asterisk) with scrotal ptosis which can be demonstrated at standing position. B). Testicular ptosis (asterisk) is pronounced when squatting. Note the imagination line of the buttock C). After varicocelectomy during which a shortening maneuvers of lagers testicular veins followed by strengthening the cord tension, resulting in scrotal elevation (dotted). D). It is for comparison with panel B.