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Varicocele
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).
Testicles
The testes are 2 egg-shaped male reproductive organs located in the scrotum. They produce sperm and the male hormone, testosterone.
Causes
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).
Varicose veins
Varicose veins are swollen, twisted, and enlarged veins that you can see under the skin. They are often red or blue in color. They most often appea...
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 .
Scrotum
The scrotum is a part of a male's body that is located behind the penis. The scrotum is the sac (pouch) that contains the testes, epididymis, and th...
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.
Kidney tumor
Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.
Symptoms
Symptoms include:
- Enlarged, twisted veins in the scrotum
-
Painless
testicle lump
,
scrotal swelling
, or bulge in the scrotum
Testicle lump
A testicle lump is swelling or a growth (mass) in one or both testicles.
ImageRead Article Now Book Mark ArticleScrotal swelling
Scrotal swelling is abnormal enlargement of the scrotum. This is the name for the sac surrounding the testicles.
ImageRead Article Now Book Mark Article - Possible problems with fertility or decreased sperm count
Some men do not have symptoms.
Exams and Tests
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.
Treatment
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:
- You will receive some type of numbing medicine (anesthesia).
- The urologist will make a cut, most often in the lower abdomen, and tie off the abnormal veins. This directs blood flow in the area to the normal veins. The operation may also be done as a laparoscopic procedure (through small incisions with a camera).
- You will be able to leave the hospital on the same day as your surgery.
- You will need to keep an ice pack on the area for the first 24 hours after surgery to reduce swelling.
An alternative to surgery is varicocele embolization. For this procedure:
- A small hollow tube called a catheter (tube) is placed into a vein in your groin or neck area.
- The provider moves the tube into the varicocele using x-rays as a guide.
- A tiny coil passes through the tube into the varicocele. The coil blocks blood flow to the bad vein and sends it to normal veins.
- You will need to keep an ice pack on the area to reduce swelling and wear a scrotal support for a little while.
This method is also done without an overnight hospital stay. It uses a much smaller cut than surgery, so you will heal faster.
Outlook (Prognosis)
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.
Possible Complications
Infertility is a complication of varicocele.
Complications from treatment may include:
- Atrophic testis
-
Blood clot
formation
Blood clot
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
ImageRead Article Now Book Mark Article - Infection
- Injury to the scrotum or nearby blood vessel
When to Contact a Medical Professional
Call your provider if you discover a testicle lump or need to treat a diagnosed varicocele.
Testicle lump
A testicle lump is swelling or a growth (mass) in one or both testicles.
References
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 www.ncbi.nlm.nih.gov/pubmed/20705202 .
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Varicocele - illustration
Incompetent or inadequate valves within the veins along the spermatic cord cause a varicocele. The abnormal valves obstruct normal blood flow causing a backup of blood, resulting in enlargement of the veins. Varicoceles usually develop slowly and usually have no symptoms. Varicoceles are a common cause of infertility in men.
Varicocele
illustration
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Male reproductive system - illustration
The male reproductive system, viewed from a sagittal section.
Male reproductive system
illustration
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Varicocele - illustration
Incompetent or inadequate valves within the veins along the spermatic cord cause a varicocele. The abnormal valves obstruct normal blood flow causing a backup of blood, resulting in enlargement of the veins. Varicoceles usually develop slowly and usually have no symptoms. Varicoceles are a common cause of infertility in men.
Varicocele
illustration
-
Male reproductive system - illustration
The male reproductive system, viewed from a sagittal section.
Male reproductive system
illustration
Review Date: 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.
