A varicocele is swelling in the scrotum associated with the backup of blood in the testicular veins.
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A varicocele is caused by a problem in the main vein of the testicle. Blood normally leaves the testicle through this vein. When blood flow through the vein is slowed, the blood backs up into smaller veins. This causes bulging of blood vessels in the scrotum.
Varicoceles typically develop in men 15-25 years old. There are no specific factors that increase your risk of getting varicoceles.
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. They may also contribute to male infertility by reducing sperm quality and/or quantity.
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:
- Semen tests
- Blood tests to look for testicular injury in adolescents
Treatment is not required for all varicoceles. Treatment is generally recommended if a varicocele is causing infertility, change in testicle size, or pain.
Options may include one or more of the following:
To help ease discomfort, your doctor may recommend over-the-counter pain relievers. In some cases, you may need to wear supportive or athletic underwear.
Surgical treatment options include:
- Open surgery—the veins are surgically cut and tied off through an incision in the groin
- Catheter ablation—heat is applied through a catheter to destroy the vein
- Catheter embolization—a substance is placed in the vein(s) 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
Reproductive Facts—American Society for Reproductive Medicine http://www.reproductivefacts.org
Urology Care Foundation http://urologyhealth.org
Health Canada https://www.canada.ca
The College of Family Physicians of Canada http://www.cfpc.ca
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- Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
- Review Date: 03/2020
- Update Date: 01/29/2021