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Varicocele

Definition

A varicocele is swelling in the scrotum due to a back up of blood in the main veins of the testicles.

Not all varicoceles require treatment. Varicoceles that interfere with fertility, cause pain, or cause other problems may require surgery.

Varicocele
testicle varices
Copyright © Nucleus Medical Media, Inc.

Causes

A varicocele is caused by a problem in the main vein of the testicle. Blood normally leaves the testicle through the spermatic vein. When this vein is not working properly, the blood gets backed up and the veins bulge.

Risk Factors

Varicoceles typically develop in men 15-25 years old. There are no specific factors that increase your risk of getting varicoceles.

Symptoms

Varicoceles may not always have symptoms. When they do appear, symptoms may include:

  • Feeling of heaviness or soreness in the scrotum.
  • Feeling enlarged, or twisted veins in the scrotum. They can feel like worms or spaghetti.
  • Veins typically change in size and are larger when standing or straining.

Varicoceles may cause the testicle to be smaller. It may also contribute to male infertility by reducing sperm quality and/or quantity.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Varicoceles are usually easily diagnosed by exam. Your doctor may recommend tests to confirm varicoceles or rule out other conditions.

Tests may include:

  • Ultrasound
  • Semen tests
  • Blood tests to look for testicular injury in adolescents

Treatment

Talk with your doctor about the best treatment plan for you. Treatment is not required for all varicoceles. Treatment is generally recommended if a varicocele is causing infertility, change in testicle size, or if it is causing pain.

Options may include one or more of the following:

Home Care

To help ease discomfort, your doctor may recommend over-the-counter pain relievers. In some cases, you may need to wear supportive underwear or a jock strap.

Surgery

Surgical treatment options include:

  • Open surgery—the vein is surgically cut and tied off
  • Catheter ablation—heat is applied through a catheter to destroy the vein
  • Catheter embolization—a substance is placed in the vein to block it
  • Laparoscopic varicocelectomy —involves the use of a thin, lighted tube inserted into the abdomen to view the vessels in the body as they lead to the testicle and block them

Prevention

There are no current guidelines to prevent varicoceles.

Revision Information

  • Reproductive Facts—American Society for Reproductive Medicine

    http://www.reproductivefacts.org

  • Urology Care Foundation

    http://www.urologyhealth.org

  • Health Canada

    http://www.hc-sc.gc.ca

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Khera M, Lipshultz LI. Evolving approach to the varicocele. Urol Clin North Am. 2008;35(2):183-189.

  • Painless scrotal mass. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/genitourinary%5Fdisorders/symptoms%5Fof%5Fgenitourinary%5Fdisorders/painless%5Fscrotal%5Fmass.html. Updated July 2013. Accessed March 7, 2016.

  • Robinson SP, Hampton LJ, Koo HP. Treatment strategy for the adolescent varicocele. Urol Clin North Am. 2010;37(2):269-278.

  • Practice Committee of the American Society for Reproductive Medicine. Report on vericocele and infertility: A committee opinion. Fertil Steril. 2014;102(6):1556-1560.

  • Varicocele in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 29, 2016. Accessed March 7, 2016.

  • Varicocele. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/teen/sexual%5Fhealth/guys/varicocele.html. Updated July 2014. Accessed March 7, 2016.

  • Varicoceles. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=116. Accessed March 7, 2016.

  • Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37(3):613-629.

The health information in this Health Library is provided by a third party. Parkridge Health System does not in any way create the content of this information. It is provided solely for informational purposes. It does not constitute medical advice and is not intended to be a substitute for proper medical care provided by a physician. Always consult with your doctor for appropriate examinations, treatment, testing, and care recommendations. Do not rely on information on this site as a tool for self-diagnosis. If you have a medical emergency, call 911.