What Is a Varicocele?

The scrotum is a skin-covered sac that holds your testicles. It also contains the arteries and veins that deliver blood to the reproductive glands. A vein abnormality in the scrotum may result in a varicocele. A varicocele is an enlargement of the veins within the scrotum. These veins are called the pampiniform plexus.

A varicocele only occurs in the scrotum and is very similar to varicose veins that can occur in the leg. A varicocele can result in decreased sperm production and quality, which in some cases can lead to infertility. It can also shrink the testicles.

Varicoceles are common. They can be found in 15 percent of the general male population. They also affect around 15 percent of teenage boys. Varicoceles generally form during puberty and are more commonly found on the left side of your scrotum.

The anatomy of the right and left side of your scrotum isn’t the same. Varicoceles can exist on both sides, but it’s extremely rare. Not all varicoceles affect sperm production.

Symptoms of a Varicocele

You may have no symptoms associated with a varicocele. However, you might experience:

  • a lump in one of your testicles
  • swelling in your scrotum
  • visibly enlarged or twisted veins in your scrotum, which are often described as looking like a bag of worms
  • a dull, recurring pain in your scrotum

Diagnosing a Varicocele

A thorough examination and some tests may be necessary to help determine if varicocele treatment is necessary. Techniques that may be necessary include:

  • Physical examination. The diagnosis of a varicocele can usually be made on physical examination of the scrotum while you are standing. A very large varicocele feels like a “bag of worms” and disappears or becomes significantly reduced when you lie down.
  • Observation. Occasionally a varicocele is so prominent that it can be seen through the skin. Often the testicle on the side of the varicocele is smaller than the other side.
  • Ancillary Tests. Testing with a Doppler stethoscope and an technetium isotope study may aid Los Angeles Fertility Specialist Dr. Werthman in making his diagnosis.
  • Scrotal Ultrasound. An accurately-performed ultrasound, in which the size of the veins and abnormal blood flow can be seen and measured, can be a very accurate means of confirming the presence of a varicocele.

When is Varicocele treatment recommended?

If you have a varicocele in one or both testicles, Dr. Werthman may recommend varicocele repair under very specific circumstances, including:

  • When you and your partner are infertile (failed to conceive after a year or more of unprotected, frequent sexual intercourse), your tested semen shows abnormal parameters, and you have a varicocele present on physical examination;
  • When a varicocele is causing you testicular pain or discomfort; or
  • When there is a significant discrepancy between the size of the two testicles.