What is it?

A varicocele is an enlargement of the veins within the loose bag of skin that holds the testicles (scrotum). These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum.

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Additional names

This group contains additional names:
- Varicocele

Signs & symptoms

A varicocele usually occurs on the left side of the scrotum and often produces no signs or symptoms. Possible signs and symptoms may include:
* Pain- A dull, aching pain or discomfort is more likely when standing or late in the day. Lying down often relieves pain.
* A mass in the scrotum- If a varicocele is large enough, a mass like a "bag of worms" may be visible above the testicle. A smaller varicocele may be too small to see but noticeable by touch.
* Differently sized testicles- The affected testicle may be noticeably smaller than the other testicle.
* Infertility- A varicocele may lead to difficulty fathering a child, but not all varicoceles cause infertility.

Diagnosis

The doctor can diagnose a varicocele by visual inspection of the scrotum and by touch. You'll likely be examined while lying down and standing up.
When you're standing, your health care provider may ask you to take a deep breath, hold it and bear down, similar to the pressure during a bowel movement. This technique (Valsalva maneuver) can make a varicocele easier to examine.

Imaging test
The doctor may want you to have an ultrasound exam. Ultrasound uses high-frequency sound waves to create images of structures inside your body. These images may be used to:
* Confirm the diagnosis or characterize the varicocele
* Eliminate another condition as a possible cause of signs or symptoms
* Detect a lesion or other factor obstructing blood flow

Treatment

A varicocele often doesn't need to be treated. For a man experiencing infertility, surgery to correct the varicocele may be a part of the fertility treatment plan.
For teenagers or young adults- generally those not seeking fertility treatmen- a health care provider may suggest annual checkups to monitor any changes. Surgery might be recommended in the following situations:
* A testicle that shows delayed development
* Low sperm count or other sperm irregularities (usually only tested in adults)
* Chronic pain not managed by pain medication

Surgery
The purpose of surgery is to seal off the affected vein to redirect the blood flow into healthy veins. This is possible because two other artery-and-vein systems supply blood circulation to and from the scrotum.
Treatment outcomes may include the following:
* The affected testicle eventually may return to its expected size. In the case of a teenager, the testicle may "catch up" in development.
* Sperm counts may improve, and sperm irregularities may be corrected.
* Surgery may improve fertility or improve semen quality for in vitro fertilization.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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