A varicocele is swelling in the scrotum due to a back up of blood in the main veins of the testicles.
Not all varicoceles require treatment. Varicoceles that interfere with fertility, cause pain, or cause other problems may require surgery.
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A varicocele is caused by a problem in the main vein of the testicle. Blood normally leaves the testicle through the spermatic vein. When this vein is not working properly, the blood gets backed up and the veins bulge.
Varicoceles typically develop in men 15-25 years old. There are no specific factors that increase your risk of getting varicoceles.
Varicoceles may not always have symptoms. When they do appear, symptoms may include:
Varicoceles may cause the testicle to be smaller. It may also contribute to male infertility by reducing sperm quality and/or quantity.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Varicoceles are usually easily diagnosed by exam. Your doctor may recommend tests to confirm varicoceles or rule out other conditions.
Tests may include:
Talk with your doctor about the best treatment plan for you. Treatment is not required for all varicoceles. Treatment is generally recommended if a varicocele is causing infertility, change in testicle size, or if it is causing pain.
Options may include one or more of the following:
To help ease discomfort, your doctor may recommend over-the-counter pain relievers. In some cases, you may need to wear supportive underwear or a jock strap.
Surgical treatment options include:
American Society for Reproductive Medicine
American Urological Association
The College of Family Physicians of Canada
Khera M, Lipshultz LI. Evolving approach to the varicocele. Urol Clin North Am . 2008;35(2):183-189.
Painless scrotal mass. Merck Manual for Health Care Professionals website. Available at: http://www.merckmanuals.com/professional/genitourinary_disorders/symptoms_of_genitourinary_disorders/painless_scrotal_mass.html . Updated February 2012. Accessed May 29, 2013.
Robinson SP, Hampton LJ, Koo HP. Treatment strategy for the adolescent varicocele. Urol Clin North Am . 2010;37(2):269-278.
The Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. American Society of Reproductive Medicine website. Available at: http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Joint_Reports/Report_on_varicocele(1).pdf . Published 2001. Accessed May 29, 2013.
Varicocele. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 10, 2013. Accessed May 29, 2013.
Varicocele. Nemours Kids Health website. Available at: http://kidshealth.org/teen/sexual_health/guys/varicocele.html . Updated May 2011. Accessed May 29, 2013.
Varicoceles. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=116 . Updated January 2011. Accessed May 29, 2013.
Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care . 2010;37(3):613-629.
Last reviewed May 2013 by Adrienne Carmack, MD; Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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