VARICOCELE

 Basic information

description

A varicocele is a tangled network of blood vessels, or varicose veins, in the testicles. Varicocele occurs more often in the left testicle than the right, and, less often, in both. They can take up to 20 years to grow large enough to be noticeable. This is a common condition, occurring in about 15% of men (often in their 20s or 30s).

FREQUENT SIGNS & SYMPTOMS

• In most cases, there are no symptoms. They may be diagnosed during a routine physical exam.
• Ache in the testicle. Sometimes they cause pain.
• Feeling of heaviness or dragging in the scrotum (the pouch of skin that contains the testicles).
• Small testicle.
• Enlarged veins can be felt (like feeling a "bag of worms"), and can make the testicle look lumpy.

causes

• Normally, blood in the testicles travels through a series of small veins into a large vein that goes up through the abdomen. A series of one-way valves in the veins prevents the reverse flow of blood back to the testicles. Sometimes, these one-way valves become damaged or defective. This causes the blood to flow backward. This reverse flow of blood stretches and enlarges the tiny veins around the testicle to cause a varicocele.
• Because of the varicocele, the blood does not cool as it does in a normal vein. The increased temperature of the blood raises the temperature of the testicles. This is believed to contribute to infertility, as heat can damage or destroy sperm. The raised temperature may also block production of new, healthy sperm.

risk increases with

Men in their 20s or 30s.

PREVENTIVE MEASURES

No known preventive measures.

expected outcomes

• Successful treatment can reduce the swelling and discomfort of varicoceles that cause symptoms.
• Treatment may help with infertility. It takes about 90 days for a sufficient quantity of new sperm to be produced to permit fertilization. Semen study is usually done at 3 and 6 months after treatment.

possible complications

• Low sperm count.
• Male infertility.
• Varicocele may recur after treatment.
• Some patients develop a condition called hydrocele. This is a fluid-filled cyst that forms around the testicle. Minor surgery is used to correct the problem.

 diagnosis & treatment

general measures

• Your health care provider will do an exam of the genital area. Varicoceles may be seen with the naked eye or by palpating (feeling) the area while a patient is standing up. Small varicoceles may be diagnosed with ultrasound or other medical tests.
• No treatment may be needed if there are no symptoms or the symptoms are mild and infertility is not an issue. Wear an athletic supporter or a pair of snug-fitting underwear to provide the scrotum with support.
• Surgery or other treatment may be recommended if the varicocele causes pain, atrophy, or infertility.
• Most varicoceles can be corrected through a surgical procedure called varicocelectomy (tying off the affected spermatic veins). It is usually performed under general or local anesthesia as an outpatient.
• Laparoscopy may be an option. It involves the insertion of a thin, lighted tube (called a laparoscope) through a small incision (cut) in the abdomen to locate and tie off the varicocele.
• A nonsurgical alternative called varicocele embolization may be recommended. A small catheter (tube) is inserted into the groin. Substances that will block the flow of blood are inserted through the catheter. The affected veins are sealed off, causing the blood flow to return to its normal path.

medications

Drugs are normally not needed.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of a varicocele.
• Varicocele symptoms recur after treatment.

Special Notes: