Varicoceles
These enlarged, distended veins often cause no symptoms but can be treated if they cause significant pain or if they affect fertility.
What are Varicoceles?
About one in five men experience varicoceles.
A varicocele is an enlargement of the veins that drain blood from the testicle. They might be barely detectable or very large and look like a “bag of worms.” Other than some discomfort, they usually have no symptoms and are often found during an evaluation for infertility.
Symptoms of Varicoceles
Typically, there are no symptoms other than a dull ache in the testicular area, which can be worse after periods of prolonged standing.
Causes Varicoceles
Left-sided varicoceles are common due to how the testicular veins connect to the larger veins in the abdomen. Often they are due to increased pressure in the veins for unknown reasons. Very rarely they can be a sign of a tumor in the abdomen.
Diagnosing Varicoceles
If you have had prior testing for a varicocele – like an ultrasound or semen analysis – bring the results to your evaluation.
Varicoceles are usually detected by physical examination. An ultrasound of the scrotum may be helpful in confirming the presence of a varicocele. If not yet done, your physician may want a semen analysis to see if the varicocele is affecting your sperm count.
Treating Varicoceles
A surgical procedure called a varicocelectomy can be performed by a urologist to reduce the pain in the testicles and improve fertility. Most men recover in about six weeks. During the procedure your physician will cut the veins and seal off the ends. Sealing the ends causes blood to flow into other healthy veins in your scrotum.
Another treatment for varicocele is available with interventional radiology. During the procedure, an interventional radiologist inserts a catheter into a tiny incision in the groin area to access the femoral vein. Using an X-ray for guidance, the catheter is guided to the testicular vein, and contrast is injected to map out the problem area so it can be blocked or embolized using coils. Once the vein is blocked, the damaged vein is shut off, and blood flow is redirected to the surrounding, healthier veins. Read more about interventional radiology treatment for varicoceles.
The whole procedure usually lasts about 30-45 minutes, with a two-hour recovery. Patients can be back to moderate activity within 24-48 hours.
