A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the scrotum, the loose bag of skin that holds your testicles. A varicocele is similar to a varicose vein that can occur in your leg.
Varicoceles are a common cause of low sperm production and decreased sperm quality, which can cause infertility. However, not all varicoceles affect sperm production. Varicoceles can also cause testicles to shrink.
Most varicoceles develop over time. Fortunately, most varicoceles are easy to diagnose and many don't need treatment. If a varicocele causes symptoms, it often can be repaired surgically.
A varicocele is enlargement of the veins that transport oxygen-depleted blood away from the testicle. ...
A varicocele often produces no signs or symptoms. Rarely, it may cause pain. The pain may:
With time, varicoceles may enlarge and become more noticeable.
When to see a doctor
However, if you experience pain or swelling in your scrotum or you discover a mass on your scrotum, contact your doctor. A number of conditions can cause a scrotal mass or testicular pain, some of which require immediate treatment.
Your spermatic cord carries blood to and from your testicles. It's not certain what causes varicoceles, but many experts believe a varicocele forms when the valves inside the veins in the cord prevent your blood from flowing properly. The resulting backup causes the veins to widen (dilate).
Varicoceles often form during puberty. Varicoceles usually occur on the left side, most likely because of the position of the left testicular vein. However, a varicocele in one testicle can affect sperm production in both testicles.
Male reproductive system
The male reproductive system makes, stores and moves sperm. Testicles produce sperm. Fluid from the seminal vesicles and prostate gland combine with sperm to make semen. The penis ejaculates semen ...
There don't appear to be any significant risk factors for developing a varicocele. However, some research suggests that being overweight may increase your risk.
A varicocele may cause:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a urologist.
Here's some information to help you get ready for your appointment, and know what to expect from your doctor.
What you can do
Preparing a list of questions will help you make the most of your time with your doctor. List your questions from most important to least important. For varicocele, some questions to ask include:
In addition to the questions you've prepared, don't hesitate to ask questions that arise during your appointment.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Your doctor will conduct a physical exam, which may reveal a twisted, nontender mass above your testicle that may feel like what's been described as a bag of worms. If it's large enough, your doctor will be able to feel it. If you have a smaller varicocele, your doctor may ask you to stand, take a deep breath and hold it while you bear down (Valsalva maneuver). This helps your doctor detect abnormal enlargement of the veins.
If the physical exam is inconclusive, your doctor may order a scrotal ultrasound. This test, which uses high-frequency sound waves to create precise images of structures inside your body, may be used to ensure there isn't another reason for your symptoms. One such condition is a tumor that compresses the spermatic vein.
Treatments and drugs
Varicocele treatment may not be necessary. However, if your varicocele causes pain, testicular atrophy or infertility, you may want to undergo varicocele repair. The purpose of surgery is to seal off the affected vein to redirect the blood flow into normal veins. However, the effect of varicocele repair on fertility is unclear.
Although varicoceles typically develop in adolescence, it's less clear whether you should have varicocele repair at that time. Indications for repairing a varicocele in adolescence include progressive testicular atrophy, pain or abnormal semen analysis results.
Varicocele repair presents relatively few risks, which may include:
Repair methods include:
Lifestyle and home remedies
If you have a varicocele that causes you minor discomfort but doesn't affect your fertility, you might try the following for pain relief:
Last Updated: 2012-01-10
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