Varicose veins - scrotum
A varicocele is the swelling of the veins inside the scrotum. These veins are found along the cord that holds up a man's testicles (spermatic cord).
A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly. Blood backs up, leading to swelling and widening of the veins. (This is similar to varicose veins in the legs).
Most of the time, varicoceles develop slowly. They are more common in men ages 15 to 25 and are most often seen on the left side of the scrotum.
A varicocele in an older man that appears suddenly may be caused by a kidney tumor, which can block blood flow to a vein. The problem is more common on the left side than the right.
You will have an exam of your groin area, including the scrotum and testicles. The health care provider may feel a twisted growth along the spermatic cord.
Sometimes the growth may not be able to be seen or felt, especially when you are lying down.
The testicle on the side of the varicocele may be smaller than the one on the other side.
A jock strap or snug underwear may help ease discomfort. You may need other treatment if the pain does not go away or you develop other symptoms.
Surgery to correct a varicocele is called varicocelectomy. For this procedure:
An alternative to surgery is varicocele embolization. For this procedure:
This method is also done without an overnight hospital stay. It uses a much smaller cut than surgery, so you will heal faster.
A varicocele is often harmless and often does not need to be treated.
If you have surgery, your sperm count will likely increase. However, it will not improve your fertility. In most cases, testicular wasting (atrophy) does not improve unless surgery is done early in adolescence.
Complications from treatment may include:
Call your provider if you discover a testicle lump or need to treat a diagnosed varicocele.
Barak S, Gordon Baker HW. Clinical management of male infertility. In: Jameson JL, De Groot LJ, de Krester DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 141.
Barthold JS. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 132.
Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37:613-626. PMID: 20705202
Last reviewed on: 8/31/2015
Reviewed by: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.