What is Varicocele?
A varicocele is a tangled network of blood vessels, or
varicose veins, in the testicles. Varicocele occurs more
often in the left testicle than the right, and, less often, in
both. They can take up to 20 years to grow large
enough to be noticeable. This is a common condition,
occurring in about 15% of men (often in their 20s or
30s).
FREQUENT SIGNS & SYMPTOMS
• In most cases, there are no symptoms. They may be
diagnosed during a routine physical exam.
• Ache in the testicle. Sometimes they cause pain.
• Feeling of heaviness or dragging in the scrotum (the
pouch of skin that contains the testicles).
• Small testicle.
• Enlarged veins can be felt (like feeling a “bag of
worms”), and can make the testicle look lumpy.
CAUSES
• Normally, blood in the testicles travels through a
series of small veins into a large vein that goes up
through the abdomen. A series of one-way valves in the
veins prevents the reverse flow of blood back to the testicles.
Sometimes, these one-way valves become damaged
or defective. This causes the blood to flow backward.
This reverse flow of blood stretches and enlarges
the tiny veins around the testicle to cause a varicocele.
• Because of the varicocele, the blood does not cool as
it does in a normal vein. The increased temperature of
the blood raises the temperature of the testicles. This is
believed to contribute to infertility, as heat can damage
or destroy sperm. The raised temperature may also
block production of new, healthy sperm.
RISK INCREASES WITH
Men in their 20s or 30s.
PREVENTIVE MEASURES
No known preventive measures.
EXPECTED OUTCOMES
• Successful treatment can reduce the swelling and discomfort
of varicoceles that cause symptoms.
• Treatment may help with infertility. It takes about 90
days for a sufficient quantity of new sperm to be produced
to permit fertilization. Semen study is usually
done at 3 and 6 months after treatment.
POSSIBLE COMPLICATIONS
• Low sperm count.
• Male infertility.
• Varicocele may recur after treatment.
• Some patients develop a condition called hydrocele.
This is a fluid-filled cyst that forms around the testicle.
Minor surgery is used to correct the problem.
GENERAL MEASURES
• Your health care provider will do an exam of the genital
area. Varicoceles may be seen with the naked eye or
by palpating (feeling) the area while a patient is standing
up. Small varicoceles may be diagnosed with ultrasound
or other medical tests.
• No treatment may be needed if there are no symptoms
or the symptoms are mild and infertility is not an
issue. Wear an athletic supporter or a pair of snug-fitting
underwear to provide the scrotum with support.
• Surgery or other treatment may be recommended if
the varicocele causes pain, atrophy, or infertility.
• Most varicoceles can be corrected through a surgical
procedure called varicocelectomy (tying off the affected
spermatic veins). It is usually performed under general
or local anesthesia as an outpatient.
• Laparoscopy may be an option. It involves the insertion
of a thin, lighted tube (called a laparoscope)
through a small incision (cut) in the abdomen to locate
and tie off the varicocele.
• A nonsurgical alternative called varicocele embolization
may be recommended. A small catheter (tube) is
inserted into the groin. Substances that will block the
flow of blood are inserted through the catheter. The
affected veins are sealed off, causing the blood flow to
return to its normal path.
MEDICATIONS
Drugs are normally not needed.
ACTIVITY
No limits.
DIET
No special diet. | 
