Varicocele

Causes

A varicocele happens when blood flowing through the main vein of the testicle is slowed. As a result, the blood backs up into smaller veins and causes them to become enlarged.

Risk Factors

Varicoceles are more common in males who are 15 to 25 years of age.

Symptoms

Some people may not have symptoms. Others may have:

• Heaviness or soreness in the scrotum
• Enlarged or twisted veins in the scrotum that may feel like worms or spaghetti
• Veins that get larger when standing or straining
• Testicles that look smaller than normal
• Fertility problems

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. This is usually enough to make the diagnosis.

Pictures of the scrotum may also be taken. This can be done with an ultrasound.

Treatment

Some people may not need treatment. They will be watched for signs of change.

Treatment may be needed if the varicocele is causing infertility, a change in testicle size, or pain. Choices are:

Supportive Care

Supportive care may be needed to ease pain. This may include taking over the counter pain relievers or wearing supportive or athletic underwear.

Surgery

Some people may need surgery. Options are:

• 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 —uses a thin, lighted tube inserted into the abdomen to view the vessels and block them

Prevention

There are no current guidelines to prevent varicoceles.