A varicocele is a disorder in which the veins coming from the testicle are dilated, or widened, because of a problem with the valves that control the flow of blood from the testicles to the body. As a result, blood tends to pool in the veins in the spermatic cord, the cord that runs from the testicle into the body.

Varicocele is a fairly common condition. Most varicoceles are noticed when a man is a teenager, but varicoceles can happen at any time in a man’s life. Because of the structure of a man’s anatomy, varicoceles are more common in the left side, but can occur in either, or both, spermatic cords.

What are the symptoms of varicocele?

Most men with avaricocele will not have symptoms. Some men, however, may feel a dull discomfort in the affected testicle, especially after exercising, standing for a long time, or at the end of the day. The discomfort will usually improve when the man lies down.

The testicle on the same side as the varicocele may be smaller than expected. If the varicocele is repaired in childhood or adolescence, the testicle may grow to “catch up” in size. Testicle size does not increase when the varicocele is repaired in adults.

What problems are caused by varicocele?

The main problemscaused by a varicocele are that it may cause pain and it may affect a man’s fertility, or his ability to have children. These are the most common reasons a man chooses to have the varicocele treated. Not all pain in the genital area is caused by a varicocele. If you are having pain, please discuss your symptoms with your doctor.

How is varicocele diagnosed?

The doctor can diagnose avaricocele during a physical examination by palpating, or feeling, the spermatic cord. A varicocele is described as feeling like a bag of worms in the scrotal sac. As mentioned, the testicle with the varicocele may be smaller than the other testicle.

In some cases, the doctor may perform an ultrasound to confirm the diagnosis. Ultrasound, also known as Sonography or Ultrasonography, is a procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographs of the inside of the body.

Semen tests and blood tests may be recommended in men with a varicocele who are concerned about their fertility.

How is varicocele treated?

The decision to treat a varicocele depends on whether you are having symptoms and on whether you are trying to have children. Men who are not having symptoms usually do not need to be treated. For men who are having mild or occasional symptoms, the following steps may be enough to control the discomfort:

• Wearing a jockstrap during exercise or prolonged standing
• Avoiding activity that causes the discomfort
• Applying ice to the scrotum and groin
• Taking the occasional over-the-counter pain reliever such as ibuprofen or acetaminophen

If these non-invasive measures do not help relieve the varicocelesymptoms, or if the man is worried about fertility, the varicocele can be treated with surgery or a procedure called an embolization. The goal of these treatments is to stop the flow of blood through the enlarged veins.

During embolization, the varicocele veins are intentionally blocked from inside the vein by causing a clot in the veins. During surgery, the varicocele veins are intentionally blocked by applying a clip or tie to the outside of the veins. Both treatments are outpatient procedures which mean that you will go home the same day as the surgery or embolization.