Varicocele is a medical word used to describe the swelling of the veins that occurs in the scrotum . Varicoceles are common. Approximately 10-20% of adolescent and young adult men have varicoceles.

What is a varicocele?

A varicocele is the swelling of the veins in the scrotum.They usually form during puberty, and may change over time.

What causes varicoceles?

A part of your body called the spermatic cord provides a connection to your testicles , and has arteries, tubes, veins, and nerves in it. Normally, the veins keep the blood flowing from the body to the heart, and the valves keep the blood flowing in the right direction. However, sometimes the valves don’t work the way they’re supposed to, and the blood flows in the wrong direction. When this happens, the blood can start to poolin the veins and causes the veins to stretch and get bigger or swell up. When the veins, called the pampiniform plexus, inside the spermatic cord get swollen it’s called a varicocele. Varicoceles are more common on the left side of the scrotum, than on the right side, due to differences in blood vessel connections on each side.

Rarely, there can be other things that can cause problems in blood flow of the pampiniform plexus, such as a mass.

How can I tell if I have a varicocele?

Because varicoceles are usually painless, many people don’t even realize that they have one until they go to their health care provider for a regular check-up.

Signs of varicoceles may include:

  • Swollen veins in your scrotum that feel kind of like worms to the touch
  • A heavy, uncomfortable, or dull aching feeling in the scrotum
  • A painless testicular lump
  • Feeling as if one testicle is larger or heavier than the other
  • Testicles that look different in size
  • Pain – some guys may feel pain when standing up which gets better when laying down

I think have a varicocele, what should I do?

If you have any of these signs or symptoms, or if you have any questions about something that just doesn’t seem right down there, it’s important to see your health care provider (HCP). Even though it might seem a little embarrassing, health care providers are trained professionals, and they see this kind of thing all the time. Your HCP will be able to tell if you do in fact have a varicocele, or if it’s something more serious.

If you ever have really bad pain in your testicle that starts suddenly, it’s important to see a health care provider immediately, or go to your local emergency room. This pain can be due to testicular torsion, which is a medical emergency. In other words, the sooner you treat it the better.

How can my HCP tell if I have a varicocele?

In order to figure out if you have a varicocele, your HCP will take a look at your groin and perform a physical exam. They will check the area around your testicles for lumps, swelling, or tenderness. Your HCP may order an ultrasound to help assess your testicles and see whether you have a varicocele or another condition. An ultrasound is painless and uses sound waves to take pictures of your testicles. It can also measure blood flow and can identify veins that aren’t working correctly.

What is the treatment for a varicocele?

If you have pain and swelling, your HCP may prescribe an over-the-counter pain reliever such as ibuprofen or acetaminophen. They may also advise you to wear snug fitting underwear or a jock strap for support and will likely monitor the size of your testicles to make sure there are no problems.

Depending on the size of your varicocele and your symptoms, your HCP may refer you to a urologist. A urologist is a doctor who specializes in the genitourinary tract, which means they specialize in the penis and testicles. Sometimes surgical procedures can help treat a varicocele. There are no medicines to treat a varicocele.

Do varicoceles cause problems?

Most small varicoceles don’t cause any problems. However, there’s a small chance that a varicocele may:

  • cause pain
  • affect the growth and size of your testicle
  • affect your fertility (being able to get a sex-assigned at birth female pregnant)
  • cause abnormal semen analysis (meaning you may have abnormal semen/sperm)

If your HCP thinks your varicocele might cause a problem, they will work with you to decide on the right treatment option for you. If you’re concerned or worried, you can always talk with your health care provider.

If you’re concerned about varicoceles, here’s a tip on how to bring it up with your health care provider: “I noticed some swelling in my scrotum.”