Have you noticed a dull ache in your scrotum or swelling around one testicle? Maybe you’ve felt a strange cluster of veins under the skin. It’s natural to wonder what’s causing these changes.
These can be varicocele symptoms. A varicocele happens when veins in the scrotum become enlarged, much like varicose veins in your legs. Some cause no problems, while others can lead to discomfort or affect fertility.
Here’s what to look for and when to see a urologist.
Can You See or Feel a Varicocele?
Larger varicoceles may look or feel like a cluster of twisted veins above the testicle. Doctors sometimes describe them as feeling like a “bag of worms.”
Smaller varicoceles can be harder to notice. You may only feel them when standing or bearing down, such as when lifting something heavy.
What Are Varicocele Symptoms?
Varicoceles don’t always cause symptoms. When they do, you might notice:
- A dull ache or feeling of heaviness in your scrotum
- A pulling or dragging sensation
- Swelling or enlarged veins you can see or feel
- Discomfort after standing for long periods or exercising
- Pain that gets worse later in the day but improves when you lie down
These symptoms happen because blood can collect in the enlarged veins when you’re standing. Lying down makes it easier for blood to drain, which can relieve the pressure.
Why Are Varicoceles Usually on the Left Side?
Most varicoceles develop on the left side, although they can affect both sides.
This happens because of how blood flows through the veins around your left testicle. Blood is more likely to back up on that side, causing the veins to swell.
Can a Varicocele Cause Testicular Swelling?
Yes. A varicocele can make one side of your scrotum look or feel fuller than the other.
The swelling usually happens above and around the testicle rather than in the testicle itself. You may notice that the veins become more visible when you stand and less noticeable when you lie down.
Sometimes, the affected testicle may also be smaller.
Can a Varicocele Affect Fertility?
Many men with varicoceles have children without any problems. But varicoceles can sometimes affect sperm production and quality, making it harder to conceive.
If you’re concerned about fertility, your urologist may recommend a semen analysis. This test checks your sperm count, movement, and other factors that affect fertility.
How Is a Varicocele Diagnosed?
Your urologist will start with a physical exam. They’ll usually examine your scrotum while you’re standing and may ask you to bear down to make enlarged veins easier to feel.
You may also need an ultrasound to check blood flow, look for enlarged veins, and measure the size of your testicles.
Does Every Varicocele Need Treatment?
Not necessarily. If your varicocele isn’t causing pain, changes in testicle size, or fertility problems, your urologist may recommend monitoring it.
Wearing supportive underwear or taking a break from activities that make the pain worse may ease mild discomfort.
Treatment may be recommended for:
- Persistent pain
- Changes in testicular growth, especially during adolescence
- Fertility problems linked to the varicocele
Two common treatment options include:
- Varicocelectomy: A surgeon closes off the enlarged veins so blood can flow through healthier veins.
- Varicocele embolization: A specialist blocks the affected veins using a thin tube called a catheter.
Both procedures redirect blood away from the enlarged veins. If fertility is a concern, treatment may also improve sperm quality over time, but results vary.
When Should You See a Urologist for Varicocele Symptoms?
It’s easy to brush off a little swelling or a dull ache, especially if it comes and goes. But if something doesn’t feel right, it’s worth finding out why. Sudden, severe testicular pain needs emergency care.
At Oregon Urology Institute, we care for men throughout Eugene and Springfield, Oregon. Our team can find out what’s causing your discomfort, answer your questions, and help you understand your options.
Schedule an appointment today and get some peace of mind.