Overview
Varicocele is common and most often occurs on the left side. In many people it causes no symptoms and is noticed during an examination for another reason.
In some cases it can be associated with pain or a heavy feeling in the scrotum, a difference in testicle size or changes in semen parameters.
When to seek a consultation
- Pain, heaviness or a dragging feeling in the scrotum
- Twisted veins that can be felt in the scrotum
- A difference in size between the testicles
- Difficulty conceiving with abnormal semen analysis
- A varicocele noticed during adolescence
Assessment
Assessment includes a physical examination standing and lying down and, if needed, a scrotal Doppler ultrasound. If there are plans for or difficulty with conception, a semen analysis may be requested.
Treatment options
Not every varicocele needs treatment. If a varicocele causes no symptoms and does not affect semen parameters, monitoring may be enough.
When treatment is needed, options may include surgically tying off the enlarged veins (including microsurgical techniques) and embolisation performed by interventional radiology. The suitable method is discussed based on the examination findings and your expectations.
Benefits, limitations and risks
The aim of treatment may be to reduce pain or to improve semen parameters, but results differ between people. Possible risks include the varicocele returning, fluid collecting around the testicle (hydrocele) and, rarely, damage to the testicle.
Frequently asked questions
Does varicocele cause infertility?
Many people with a varicocele are able to have children. In some, it can affect semen parameters, which is why assessment is individual.
Does a varicocele go away on its own?
It usually does not disappear on its own, but a varicocele that causes no symptoms may not need treatment, and monitoring may be enough.