Varicocele

Varicocele is when veins in your scrotum swell and get larger. It’s a lot like a varicose vein that you get in your leg. It might feel like a bag of worms.

Causes of Varicocele #

• Doctors aren’t sure what causes this condition.

• It could be a problem with blood flow in the spermatic cord, which carries blood to and from your testicles.

• If valves inside the veins in the cord don’t work like they should, the blood backs up and the veins get wider.

• Each testicle has a spermatic cord holding it up.

• The spermatic cord has veins, arteries, and nerves.

• The veins have valves that keep blood flowing in one direction toward the heart.

• If a valve in the spermatic cord doesn’t close the way it should, blood backs up and causes a varicocele.

Symptoms of Varicocele #

Varicoceles rarely hurt. You may not even know you have one until you or the doctor sees it.

If yours does cause pain, it might:

• Switch from dull to sharp

• Get worse when you stand or exert yourself, especially for a long time

• Become more intense as the day goes on

• Go away when you lie on your back

You may also have problems fathering a child. Varicoceles are one of the most common causes of infertility in men. Treating your varicocele should improve your sperm and help with infertility issues.

Diagnosis of Varicocele #

• You and the doctor may be able to feel the mass easily.

• If not, the doctor might ask you to stand, take a deep breath, and hold it while you bear down.

• They’ll call this the Valsalva maneuver. It helps them feel enlarged veins.

• If the exam isn’t enough to be sure, they might take an ultrasound of your scrotum.

• A scrotal ultrasound uses sound waves to take pictures of the inside of your body.

• The pictures can tell your doctor how large the veins in your scrotum are, how large your testicles are, and which direction the blood is flowing in your scrotal veins.

• The size of the lump in your testicle helps your doctor classify your varicocele on a grading scale of 0-3.

• A Grade 0 is the smallest, and can be seen only with the help of an ultrasound.

• Grade 3 is the largest, and means your varicocele is big enough that it changes the shape of your scrotum.

Treatment of Varicocele #

Varicocelectomy #

The doctor will make a 1-inch cut into your scrotum. They’ll use a magnifying glass or microscope to see small veins better. You might get local anesthesia to numb the area, or you may need general anesthesia to help you sleep through the procedure.

Laparoscopic surgery #

The doctor makes a much smaller cut and uses it to insert tubes that hold surgical tools and a special camera to help see inside you. You’ll get general anesthesia so you can sleep while it’s done.

Percutaneous embolization #

With this less common treatment, a doctor called a radiologist will cut into a vein in your groin or neck to insert a tube. They’ll use X-rays to guide them to the varicocele and insert a balloon or coil into it through the tube. This blocks the blood flow to the varicocele and shrinks it. You’ll have this done with general anesthesia.