Varicocele

What is a varicocele?

A varicocele is a group of enlarged blood vessels that is found around one or both testicles of some boys and men. The vessels are veins. The veins are in their normal position and are normal in their number. What is not normal is that the veins are swollen and much bigger than their normal size. A varicocele can be felt through the skin of the scrotum (sac that holds the testicles). Each swollen vein is about the size of a thin straw. Some people describe a varicocele as "a bag of worms."

About 1 in 5 men (20%) have a varicocele. In men that have fertility problems, about 40% have a varicocele.

What is the cause?

The enlarged blood vessels are caused by slow moving blood in the veins in that area of the body. A varicocele is more common in the left scrotum than the right. This is because of differences in the way blood returns from this area of the body towards the heart. A varicocele on the left side only is common. Varicoceles in both sides of the scrotum are less common.

What are the symptoms?

Often there are no symptoms. Sometimes however, it may cause the testicle to have a dull, achy feeling. Some boys have painful swelling. Symptoms may develop gradually, long after the varicocele is first discovered. Varicoceles usually get bigger when the boy holds his breath and bears down. They normally collapse when the boy lies down.

How is it diagnosed?

A varicocele is usually noticed by your healthcare provider during a routine check-up. A varicocele found only on the right side is very uncommon. Your child's healthcare provider will want to do some tests to make sure there is not another reason for the problem if it is only on the right side.

Varicoceles are usually first found during the teenage years, but they occasionally happen before puberty. Every newly discovered varicocele should be examined by a healthcare provider.

What is the treatment?

Most varicoceles do not cause any medical problems and no treatment is needed.

Sometimes, the varicocele is very large and the veins may cause a lot of discomfort, or a lab test of semen may show that your child is at risk for having fertility problems. Why this happens is not known. Some experts think it may have to do with the blood keeping the testicle too warm. In these cases, surgery may be recommended to repair the veins. A surgeon may explain different treatment methods to correct the problem.

When should I call my child's healthcare provider?

Call during office hours if:

• your son is complaining of minor testicular discomfort.
• you have questions about the treatment of a varicocele.

Bring your child in for immediate care if:

• your child is having severe scrotal pain.