The reasons why varicoceles occur are numerous but the most common reason is that the valves in the veins are defective. These valves usually close and prevent backflow of blood into the scrotal veins. When the valves are defective the veins get engorged with blood. In the elderly male, the reason why varicoceles occur is that they may be a blockage of the veins draining the scrotum. The blockage is usually due to a cancer or a mass.
In some males, there may be a history of trauma to the groin or scrotum and this may have disrupted the vein or the valves. The reason why varicoceles are most common on the left side is due to the anatomical differences in drainage of the veins from the scrotum.
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