Varicocele
A varicocele is an enlargement of the veins within the scrotum, similar to varicose veins that occur in the legs. It most commonly affects the left side and can cause a feeling of heaviness, dull pain, or decreased fertility in some individuals. Many varicoceles are harmless and found incidentally, while others may interfere with testicular function or sperm production.
What is it?
A varicocele forms when valves in the scrotal veins do not function properly, allowing blood to pool and causing the veins to enlarge. This enlargement may be more noticeable when standing or straining. Varicoceles often develop during puberty and may gradually increase in size over time.
Ultrasound is the preferred imaging test to confirm a varicocele, showing enlarged veins and increased blood flow with certain maneuvers such as the Valsalva maneuver. Imaging can also help determine whether the varicocele is typical or related to another condition that affects blood flow.
Important to Know
Most varicoceles do not require treatment unless they cause discomfort, testicular atrophy, or fertility problems. When needed, procedures such as embolization or surgical ligation can improve symptoms or sperm quality. Regular monitoring may be recommended for adolescents or individuals with borderline symptoms.
Red flag symptoms include sudden severe scrotal pain, swelling, fever, or a varicocele that appears suddenly, especially on the right side—these may indicate another underlying condition requiring urgent evaluation.