Varicocele: Symptoms, Causes, and Treatment

Many men with fertility problems and reduced semen quality are diagnosed with varicocele, an enlargement of the veins in the scrotum.

This potentially painful condition can cause infertility, so it’s important to understand what symptoms you may experience and why your varicocele was diagnosed in the first place.

What is Varicocele?

Varicocele is a condition that affects the veins in the scrotum.

The scrotum is the sac that holds the testicles. The veins in the scrotum are responsible for carrying blood away from the testicles. When these veins become enlarged, it’s called varicocele.

Many people with varicoceles do not experience any symptoms. However, when present, symptoms may include pain or discomfort in the testicle area (less common), low-grade fever (less common), and a general feeling of heaviness or discomfort in the scrotum (more common).

In some cases, there may be tenderness on one side of the scrotum due to blockage of venous drainage by an enlarged vein on that side of the body.

Causes of Varicocele

The exact varicocele causes are unknown. However, it’s thought that they may be caused by abnormal development of the veins in the testicles. This can happen during fetal development or after puberty.

In some cases, varicoceles may be caused by an injury to the testicles. Other possible causes include a clotting disorder or testicular torsion (when the testicle twists within its protective sac).

Men who have a history of kidney stones should also talk with their doctor about the risk for this condition.

If a man has had one episode of kidney stones, he has a 15% chance of developing them again. For men who have had two episodes, the likelihood increases to 30%.

Kidney stones are more common among men because they produce less urine than women. Therefore, there is more concentrated urine sitting in the bladder and collecting bacteria than would otherwise be present if there were more frequent urination as with women.

Symptoms of Varicocele

The most common varicocele symptom is a dull ache in the testicle on the affected side. The testicular pain may worsen with prolonged standing or sitting.

Other symptoms may include:

• A heavy or dragging feeling in the scrotum
• Enlargement of the veins in the scrotum
• Testicular atrophy (shrinking)
• Worsening fertility
• Swelling in the scrotum
• A weak stream of urine when you pee.

It’s important to see a doctor even if you don’t have any symptoms because varicoceles can lead to serious complications later on.

Diagnosis of Varicocele

The scrotum will be visually inspected and touched to assess the possibility of a varicocele. The examination is typically conducted while you’re standing and while you’re lying down.

As you stand, your health care provider may ask you to take a deep breath, hold it and bear down, similar to how you do during a bowel movement. The Valsalva maneuver can make examining a varicocele easier.

Treatments for Varicocele

A few different varicocele treatments are available, depending on the severity of the condition.

In some cases, no treatment is necessary. For milder cases, treatment may involve wearing special support stockings or taking over-the-counter pain relievers. For more severe cases, surgery may be necessary to remove the varicocele.

Varicocelectomy

Doctors might sometimes recommend a surgery called varicocelectomy. A surgeon makes an incision in the groin area and removes one or both of the enlarged veins that are causing the problem.

If only one vein is removed, it’s typically done by ligation (tying off) because removing it surgically can lead to complications such as bleeding or scarring. If both veins are removed, they’re usually tied off so they can heal before removal from circulation.

Laparoscopic surgery

One type of surgery used to correct varicoceles is laparoscopic varicocelectomy. Doctors insert a small tube with a camera attached through an incision near the navel and make another incision near the testicles.

They then cut away excess tissue from inside the scrotum and repair any abnormal connections between arteries and veins. Afterwards, surgeons seal off each end of the abnormal vessel connections using heat-activated clamps known as sutures.

Percutaneous embolization

Another procedure performed to stop blood flow coming from the varicocele is percutaneous embolization. With this technique, doctors inject tiny particles into the larger veins that supply blood to the varicocele.

The particles block blood flow, and pressure in the vessels decreases until they shrink away completely. Endovascular procedures have been found to have higher success rates than other types of treatments, but there are still risks involved with these techniques.

Recovery

In most cases, the varicocele surgery can be done on an outpatient basis, which means you won’t have to stay in the hospital overnight. Recovery from the surgery is usually quick, and you can expect to return to normal activities within a week or so.

However, there are some possible side effects of surgery that you should be aware of before deciding whether or not to undergo this procedure.

For example, a low sperm count might result from removing the affected veins, although it’s rare for it to happen with just one operation.

Additionally, if you’re not completely cured after one operation (which happens in about 5% of cases), then additional procedures might be necessary down the line.

Risks and complications of varicoceles

Varicoceles are often harmless and don’t require treatment. However, in some cases, they can cause fertility problems. They may also increase the risk of testicular torsion (twisting of the spermatic cord) or testicular rupture.

Surgery is sometimes recommended for men who want to conceive a child but have varicoceles. If surgery is not an option, the male partner should avoid contact sports or any activity that might lead to trauma during sex.

The female partner should undergo tests to ensure she doesn’t have a condition like pelvic inflammatory disease that would make it more difficult for her to get pregnant.

Both partners will need regular checkups as well as consultation with specialists in reproductive medicine.

Conclusion

If you are experiencing any varicocele symptoms, visit the CK Birla Hospital or book an appointment with Dr. T C Sharma. We will help you develop a treatment plan that is best suited for your condition, besides providing you with information on the causes and symptoms of varicoceles. 

FAQs

Can varicocele be cured?

Treatment for varicocele includes surgery to remove the swollen veins that are in the scrotum. Other treatment options include injecting certain drugs to destroy the enlarged veins or radiation therapy. 

What happens if a varicocele is left untreated?

If left untreated, the varicocele may cause infertility in men due to damage to the spermatic cord and blood vessels by persistent pressure on them. It also may lead to chronic pain, swelling and lower back pain.

Can varicoceles disappear naturally?

Rarely, but it could happen over time as the body compensates.

Most of the time, this condition doesn’t go away without treatment and will get worse over time. Not only do the varicose veins become more dilated, but there is an increase in the connective tissue around the veins, which does not allow them to return to their normal size.

What is the natural way to cure varicocele?

There is no natural way to cure varicocele. However, preventive methods include wearing supportive underwear and avoiding high-intensity exercises like biking, running, weightlifting or heavy lifting.