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Varicocele (Swollen Veins Around Testicle)


 What is a varicocele?
 What is the cause?
 What are the symptoms?
 How is it diagnosed?
 How is it treated?
 How can I take care of myself?

Male Pelvis: Illustration
Male Pelvis: IllustrationClick here to view a full size picture.

What is a varicocele?

A varicocele is a group of swollen veins around one or both testicles. The testicles are part of the male reproductive organs. They are in a sac of loose skin, called the scrotum, which is below and behind the penis. The testicles make sperm and the male hormone, testosterone.

A varicocele can be felt through the skin of the scrotum. Each swollen vein is about the size of a thin straw.

Varicoceles are usually first found during the teenage years, but they occasionally happen before puberty.

Most varicoceles don’t cause problems and no treatment is needed. However, sometimes a varicocele can cause the testicles to shrink, which can affect the functioning of the testicles. About 40% of men with fertility problems have a varicocele. Doctors aren’t sure how the varicocele might affect a man’s ability to have a child. Some think that the blood in the swollen veins may keep the testicle too warm, which can lower the sperm count and movement of the sperm.

What is the cause?

Doctors think that the enlarged blood vessels are caused by blood that isn’t flowing properly in the veins around the testicles. This may happen because valves in the veins that should be keeping the blood flowing in one direction are not working properly. As a result, the blood backs up and causes the veins to get wider.

A varicocele is more common in the left testicle than the right. This is because of differences in the way blood flows from this side of the body towards the heart.

What are the symptoms?

Often there are no symptoms. Sometimes however, the testicle may have a dull, achy feeling. There may be some painful swelling.

Symptoms may develop gradually, long after the varicocele is first discovered. The varicocele will usually get bigger when you hold your breath and bear down. It will normally collapse when you lie down.

How is it diagnosed?

A varicocele is usually noticed by your healthcare provider during a routine checkup.

A varicocele found only on the right side is very uncommon. In this case, some tests may be done to make sure there is not another reason for the problem.

How is it treated?

A varicocele should be examined by a healthcare provider. Usually it doesn’t need any treatment, but surgery to repair the veins may be recommended if:

The purpose of surgery is to seal off the veins with poor blood flow and redirect the blood flow into other, normal veins.

Doctors aren’t sure if surgery will help fertility problems but it may help prevent shrinking of the testicles.

How can I take care of myself?

If you have pain or swelling, your healthcare provider may recommend anti-inflammatory medicine to relieve it. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

It can also help to wear snug underwear or a jock strap for support. This can be especially helpful during heavy physical activities or when you are standing for a long time.

Ask your healthcare provider what symptoms or problems you should watch for and what to do if you have them.

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References

"Varicocele: Urology." EMedicine - Medical Reference. Web. .

Baazeem A, Belzile E, Ciampi A, Dohle G, Jarvi K, Salonia A, Weidner W, Zini A. Varicocele and Male Factor Infertility Treatment: A New Meta-analysis and Review of the Role of Varicocele Repair. Eur Urol. 2011 Oct;60(4):796-808. Epub 2011 Jul 5.

Bogaert G, et al. Pubertal screening and treatment for varicocele do not improve chance of paternity as adult. J Urol. 2013 Jun;189(6):2298-303.

Choi WS, and Kim SW. Current issues in varicocele management: a review. World J Mens Health. 2013 Apr;31(1):12-20.

Fayad F, Sellier N, Chabaud M, Kazandjian V, Larroquet M, Raquillet C, Ajavon Y, Audry G, Grapin C, Auber F. Percutaneous retrograde endovascular occlusion for pediatric varicocele. J Pediatr Surg. 2011 Mar;46(3):525-9.

Moreira-Pinto J, Osório AL, Carvalho F, de Castro JL, de Sousa JF, Enes C, Reis A, Cidade-Rodrigues JA. Varicocoelectomy in adolescents: laparoscopic versus open high ligation technique. Afr J Paediatr Surg. 2011 Jan-Apr;8(1):40-3.

Park YW, Lee JH. Preoperative predictors of varicocelectomy success in the treatment of testicular pain. World J Mens Health. 2013 Apr;31(1):58-63.

Raheem OA. Surgical management of adolescent varicocele: Systematic review of the world literature. Urol Ann. 2013 Jul;5(3):133-9.

Testicular Symmetry and Adolescent Varicocele-Does it Need Followup? J Urol. 2011 Oct;186(4 Suppl):1614-9.



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Last Modified: 2012-02-09

Last Reviewed: 2013-10-20

Website Updated: October 2014

Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado.
Published by RelayHealth. © 2014 RelayHealth and/or one of its affiliates. All Rights Reserved.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.


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