15239 Varicocele

Overview

A varicocele is a group of enlarged veins in the scrotum — the skin sack that holds the testicles. It’s similar to varicose veins you can get in your legs. These veins carry blood away from the testicles. When they don't work properly, blood can pool and make the veins swell.

Yes. Varicoceles are very common. About 1 in 7 men have one. Most are harmless and never cause any trouble.

They most often affect teen boys and young adult men. They can also appear later in life, but that is less common.

Symptoms

Common symptoms

• A dull, heavy, or aching pain in the scrotum
• A lump above the testicle, sometimes described as feeling like 'a bag of worms'
• Swelling or a heavy feeling in the scrotum
• Pain that gets worse after standing, walking, or exercising and goes away when lying down

Symptoms in children

• Often no symptoms at all
• Sometimes a painless lump or a feeling of heaviness in the scrotum
• A parent may notice that one testicle is smaller than the other

Symptoms in older adults

• A new ache or fullness in the scrotum
• Swollen veins you can feel or see
• Because a new varicocele later in life can be linked to other conditions, it should always be checked by a doctor

Causes

Main causes

• The veins in the scrotum have tiny flaps (valves) that keep blood flowing upward toward the heart. When these valves don't work well, blood can flow backward and pool in the veins, making them enlarge.
• The problem often happens because of how the veins are arranged on the left side of the body, which makes it easier for blood to flow backwards.

Risk factors

• Being between 15 and 25 years old
• Having a close family member with a varicocele
• Having certain anatomy that lets blood flow backward in the veins

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have a new lump, sudden pain, or swelling in the scrotum.

Book a routine appointment if:

• Make an appointment if you have ongoing discomfort in the scrotum.
• Talk to a doctor if you are worried about fertility or have noticed a change in the size of your testicles.

Diagnosis

A doctor can often feel a varicocele during a physical exam. They may ask you to stand, take a deep breath, and bear down gently (like having a bowel movement) to make the veins more noticeable.

Tests that may be done

• Ultrasound (a test that uses sound waves to create a picture of the inside of your body) to confirm the diagnosis and check the size of the testicles
• If fertility is a concern, a semen analysis may be recommended to check sperm count and quality.

What to expect at your appointment

The exam is quick and usually painless. You will be asked to lower your underwear so the doctor can inspect your scrotum. If you have questions, it's okay to ask the doctor to explain what they are doing and why.

Treatment

Treatment for a varicocele is not always needed. Your doctor may suggest it if you have pain, if the testicle on the affected side is not growing normally (especially in teens), if it is causing fertility problems, or if you and your doctor decide it's the best choice for your situation.

Self-care at home

• Wear supportive underwear or an athletic supporter, especially during exercise.
• Take regular breaks from long periods of standing or sitting.
• Apply a cool compress to the scrotum for short periods to help ease discomfort.

Medical treatments

Treatments include procedures to block the faulty veins (called embolization) or surgery to tie off the enlarged veins (called ligation). These are done by a specialist, such as a urologist. Your doctor will explain the options and help you decide what's best for you.

When is surgery considered?

Surgery is usually considered when a varicocele causes persistent pain, when it may affect fertility, or when a boy's testicle is not growing as expected.

Living with this condition

Most people with a varicocele live completely normally. You do not need to change your routine unless you have symptoms. Simple comfort measures, like wearing supportive underwear, can make a big difference.

Lifestyle tips

• Avoid standing or sitting for very long periods without taking a break.
• If exercise makes your pain worse, try lower-impact activities like swimming or cycling.
• Wear supportive underwear or an athletic supporter during sports.

Diet and exercise

No specific diet prevents or cures a varicocele. Eating a balanced diet and staying physically active supports overall vein health. Regular gentle exercise may also help with stress and discomfort.

Mental health and emotional wellbeing

It is normal to feel anxious or stressed if you notice a lump or worry about fertility. Talk to your doctor about your concerns. They can give you accurate information and reassurance to help you feel more at ease.

Prevention

There is no proven way to prevent a varicocele. It is a physical problem in the veins that lifestyle choices cannot change.

Screening programmes

There is no routine screening test for varicocele. Your doctor may check for it during a normal physical exam, especially if you have symptoms or concerns.

Complications

If left untreated

• Possible fertility problems, as a varicocele can affect the number and quality of sperm
• Shrinkage (atrophy) of the testicle on the affected side
• Chronic discomfort or pain in the scrotum

Long-term outlook

For most men, a varicocele never causes any health problems or changes to fertility. When treatment is needed, it is usually very effective. Many men who have treatment see improvement in their sperm health. The outlook is very good.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.