Is a Varicocele?
The scrotum is a skin-covered sac that holds your testicles. It
also contains the arteries and veins that deliver blood to the reproductive
glands. A vein abnormality in the scrotum may result in a varicocele. A varicocele is an enlargement of the veins
within the scrotum. These veins are called the pampiniform plexus.
A varicocele only occurs
in the scrotum and is very similar to varicose veins that can occur in the leg.
A varicocele can result in decreased sperm production and quality,
which in some cases can lead to infertility. It can also shrink the testicles.
Varicoceles are common. They can be found in 15 percent of the
general male population. They also affect around 15 percent of teenage
boys. Varicoceles generally form during puberty and are more commonly found on
the left side of your scrotum.
The anatomy of the right and left side of your scrotum isn’t the
same. Varicoceles can exist on both sides, but it’s extremely rare. Not all
varicoceles affect sperm production.
Causes a Varicocele to Develop?
A spermatic cord holds up each testicle. The cords also contain
the veins, arteries, and nerves that support these glands. In healthy veins
inside the scrotum, one-way valves move the blood from the testicles to the
scrotum, and then they send it back to the heart. Sometimes the blood doesn’t
move through the veins like it should and begins to pool in the vein, causing
it to enlarge.
There are no established risk factors for developing a varicocele,
and the exact cause is unclear.
A varicocele develops slowly over time. Most males are diagnosed
between the ages of 15 and 25.
the Symptoms of a Varicocele
You may have no symptoms associated with a varicocele. However,
you might experience:
- a lump in one of your testicles
- swelling in your scrotum
- visibly enlarged or twisted veins in your
scrotum, which are often described as looking like a bag of worms
- a dull, recurring pain in your scrotum
The condition can have an effect on fertility. Varicocele is
present in 35
percent of men with primary infertility and
in 75 to 80
percent of males with secondary infertility. Primary infertility is generally used to refer to a couple
that hasn’t conceived a child after at least one year of trying. Secondary infertility describes
couples that have conceived at least once but aren’t able to again.
Is a Varicocele Diagnosed?
Your doctor usually diagnoses the condition after a physical exam.
A varicocele can’t always be felt or seen when you’re lying down. Your doctor
will most likely examine your testicles while you’re standing up and lying
Your doctor may need to perform a scrotal ultrasound. This helps
measure the spermatic veins and allows your doctor to get a detailed, accurate
picture of the condition.
Once the varicocele is diagnosed, your doctor will classify it
with one of three clinical grades. They are labeled grades 1 through 3,
according to the size of the lump in your testicle. Grade 1 is smallest and
grade 3 the largest. The size doesn’t necessarily affect the overall treatment
because you may not require treatment. Treatment options are based on the
degree of discomfort or infertility issues you have.
of Treatment for Varicoceles
It’s not always necessary to treat a varicocele. However, you may
want to consider treatment if:
- your varicocele causes pain
- your varicocele causes testicular atrophy
- your varicocele causes infertility
- you’re thinking about assisted reproductive
This condition can cause problems with testicular functioning in
some people. The earlier you start treatment, the better your chances of
improving sperm production.
Wearing tight underwear or a jock strap can sometimes provide you
with support that alleviates pain or discomfort. Additional treatment such as
varicocelectomy and varicocele embolization might be necessary if your symptoms
A varicocelectomy is a same-day surgery that’s done in a hospital.
A urologist will go in through your abdomen and clamp the abnormal veins. Blood
can then flow around the abnormal veins to the normal ones. Talk with your
doctor about how to prepare for the surgery and what to expect after the
Varicocele embolization is a less invasive, same-day procedure. A
small catheter is inserted into a groin or neck vein. A coil is then placed
into the catheter and into the varicocele. This blocks blood from getting to
the abnormal veins.
Infertility is a common complication of a varicocele. Talk to
your doctor about seeing a reproductive specialist if you and your partner are
having problems getting pregnant.
Surgery is only necessary if the varicocele is causing you pain
or if you’re trying to have a child.
Talk to your doctor about which treatment is right for you.