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Varicocele

Definition

A varicocele is when the veins along the spermatic cord dilate (widen). The spermatic cord suspends the testicles in the scrotum.

Causes, incidence, and risk factors

A varicocele occurs when the valves within the veins along the spermatic cord don't work properly. The abnormal valves prevent normal blood flow and cause blood to backup, which dilates and enlarges the veins. (This is essentially the same process as varicose veins, which are common in the legs.)

Varicoceles usually develop slowly and may not have any symptoms. They are more common in men between 15 and 25 years old. Varicoceles are more common on the left side. Varicoceles are often the cause of infertility in men.

The sudden appearance of a varicocele in an older man may be caused by a kidney tumor that has affected the renal vein and altered the blood flow through the spermatic vein.

Symptoms

Signs and tests

If you have a varicocele, your physician may feel a non-tender, twisted mass along the spermatic cord. (It feels like a bag of worms.) However, the mass may not be able to be felt or obvious, especially when lying down. The testicle on the side of the varicocele may or may not be smaller compared to the other side.

Treatment

Varicoceles may be managed with a scrotal support. However, if pain continues, or if infertility or testicular atrophy results, further treatment may be needed. Treatments include open surgical removal, laparoscopic removal, and catheter embolization.

Both open and laparoscopic varicocelectomy (the surgical correction of a varicocele) are performed on an outpatient basis. The cut is usually made in the lower abdomen, although various techniques can be used. Ice packs should be kept to the area for the first 24 hours after surgery to reduce swelling.

Catheter ablation is also done as an outpatient procedure.  A small puncture is made at the crease where the leg joins the body.

You will be advised to use ice and to wear a scrotal support for some time after surgery. Possible complications include hematoma (blood clot formation), infection, or injury to the scrotal t issue or structures. In addition, injury to the artery that supplies the testicle may occur.

Expectations (prognosis)

A varicocele is usually harmless and often requires no treatment. If surgery is required because of infertility or testicular atrophy, the outlook is usually excellent.

Calling your health care provider

Call for an appointment with your health care provider if you discover a testicle lump or need to treat a diagnosed varicocele.

Illustrations

Varicocele
Varicocele
Male reproductive system
Male reproductive system

Page Content:

Varicose veins - scrotum ; varicose vein in the scrotum; scrotum varicose vein