WHAT IS VARICOCELE?

Varicoceles are usually harmless and often don’t cause any symptoms. However, some men may feel a dull ache or a heavy feeling in the scrotum. In more serious cases, varicoceles can affect sperm production and quality, which might result in fertility challenges, making it harder to have children.

The most common symptoms associated with this condition include:

• Dull pain or discomfort. You might feel a dull ache or heaviness in the affected testicle, especially after standing or being active.
• Visible veins. Larger varicoceles can make the veins in your scrotum look or feel ropy or thready.
• Shrinking testicle. The affected testicle may get smaller, a condition called testicular atrophy.
• Infertility. If you’ve been trying to have a baby for a year or more without success, a varicocele could be part of the reason.

The exact cause isn’t fully known. One reason might be that the valves in the veins don’t work correctly, causing blood to pool or flow backward, leading to enlarged veins. The left testicular vein also takes a slightly different route than the right, making it more likely for blood flow problems to occur on that side. Varicoceles can occur at any age but are often first noticed during puberty when blood flow to the genitals increases.

Your doctor will perform a physical exam. You may be asked to stand and perform a Valsalva maneuver, in which you take a deep breath, hold it, and strain as if you’re trying to exhale with your nose and mouth closed. This maneuver helps your doctor feel for enlarged veins.

Additional tests may be performed, including:

• An ultrasound imaging test that provides a detailed view of the veins in your scrotum
• A semen analysis to check the health of your sperm
• A blood test to measure hormone levels, including testosterone

Conservative management

Treatment might not be necessary for mild cases with minimal or absent symptoms. If symptoms are present, simple at-home actions can be taken to help manage discomfort, such as:

• Wearing tight-fitting underwear or a jockstrap to support the scrotum and relieve pain.
• Applying ice or a cold pack wrapped in a towel to the scrotum for short periods to reduce swelling and discomfort.
• Taking over-the-counter pain relievers like ibuprofen or naproxen.

Surgical options

If a varicocele causes significant pain or affects fertility, your doctor might recommend a surgical procedure called a varicocelectomy.

During this procedure, a surgeon will cut and tie off the affected veins, allowing blood to flow through healthier veins in the scrotum. The surgery can help reduce symptoms.

In addition, removing the affected veins and restoring normal blood flow can help improve sperm quality and increase the chances of conception. However, the surgery’s success varies, so discussing the potential benefits and risks with your doctor is important.

Can a varicocele be prevented?

Unfortunately, there’s no known way to prevent a varicocele because the exact cause isn’t fully understood.

Do I need treatment for my varicocele?

Not everyone requires treatment. If it doesn’t cause pain, discomfort, or fertility issues, treatment may not be necessary. However, if you experience significant symptoms, your doctor may recommend treatment options to manage the condition.

Will my symptoms get worse without treatment?

In many cases, varicoceles remain stable and do not worsen over time. However, the symptoms may gradually become more noticeable or bothersome for some men, especially if the varicocele gets bigger. Regular check-ups and monitoring for testicular changes are essential.

Could a varicocele affect my fertility?

Yes, it can. If you’re trying to conceive and suspect a varicocele may be affecting your fertility, your doctor will be able to help you explore options that might improve your chances of achieving pregnancy.