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.
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.
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. It may also contribute to male infertility by reducing sperm quality and/or quantity.
Your doctor will ask 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
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:
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.
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
- Laparoscopy —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
There are no current guidelines to prevent varicoceles.
Reproductive Facts—American Society for Reproductive Medicine
Urology Care Foundation
The College of Family Physicians of Canada
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Last reviewed January 2015 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.