Varicocele overview
A varicocele (“varix”, dilated vein and “cele”, tumor/swelling) is a collection of dilated (varicose) veins involving the scrotum. These veins can cause a swelling or enlargement of one testicle due to the abnormally large veins. This abnormality can be present in 10-12% of men and can be a cause of infertility.
Dr. Julian Javier discusses varicocele and pelvic congestion syndrome which can cause groin pain.
Varicocele causes
The anatomical defect in responsible for varicoceles is vein dilatation that results in blood reflux and pooling of blood in the testicular sac. These refluxing (leaking) veins prevent the normal flow of blood returning to the heart.
Varicocele symptoms
The reported symptoms vary widely with the size and severity of the refluxing vein. Symptoms are more often left sided and may include testicular pain, scrotal swelling, a heavy scrotal sensation; these symptoms tend to become more severe upon standing and at the end of the day. Varicoceles may result in infertility.
Varicocele diagnosis
A detailed history of your presenting symptoms and system review is obtained, this is followed by a physical examination. Your doctor will likely recommend an ultrasound, which is a non-invasive method that can visualize the dilated scrotal veins.
In some cases, an invasive venogram is necessary to evaluate the leaking vein in more detail and to plan a treatment strategy to correct the problem.
Varicocele treatment strategies
Patients who report no symptoms or minimal symptoms can be treated safely with a conservative strategy.
If pain is significant or there are lifestyle limitations due to the varicocele, corrective treatment is recommended. Surgical procedures to tie off the vein with surgical sutures as well as minimally invasive catheter-based procedures to seal off the vein are available and are associated with a high likelihood of success.
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