Introduction

Photo of a couple walking through a vineyard (PantherMedia / Phovoi R.) Varicoceles are varicose veins in the scrotum. They form in the veins that run along the spermatic cord. Blood from the testicles flows back into the body through those veins. Like varicose veins in the legs, varicoceles form when blood builds up in the veins and they become permanently enlarged.

Symptoms

Varicoceles do not normally cause any symptoms. But they can sometimes lead to swelling, tension or pain in the testicles.

Prevalence

Varicoceles are quite common. Around 15% of all men have a varicocele at some point in their life.

Effects

It is thought that varicoceles can affect fertility. Varicoceles are fairly common in men who have fertility problems. It is estimated that around 25% of all men with poor sperm quality have a varicocele. But varicoceles don’t always affect fertility: Many men with varicoceles do not have fertility problems.

Diagnosis

Larger varicoceles can be detected just by touch. These are referred to as palpable varicoceles. Smaller varicoceles can only be found using ultrasound (sonography).

Treatment

Varicoceles do not normally need to be treated. But some experts do suggest treatment for men who have fertility problems and a varicocele, in the hope that it will improve fertility.

The treatment involves “shutting down” the affected vein so that the blood flows through healthy, neighboring veins instead. This can be done by blocking the vein using minimally-invasive procedures (embolization) or by performing varicose vein surgery. In embolization, the affected vein is blocked using a catheter to inject either a solution that causes scarring (sclerotherapy), a tissue adhesive, or a detachable balloon or coil. In surgery, the swollen vein and the surrounding smaller veins are either cut or tied.

Research summaries

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