What is varicocele?

Varicocele is a common disorder that causes the veins in your scrotum to become enlarged. Your scrotum is the sac of skin behind your penis that normally contains your testicles. Varicocele are similar to varicose veins. Varicose veins cause the veins in your legs to swell and lose their shape.

Varicocele are usually painless but can sometimes cause testicular pain, which may come and go. In some people, varicocele can cause infertility. If the varicocele doesn’t bother you, you won’t need treatment.

Is varicocele serious?

Varicocele is not life threatening. However, varicocele can be very serious if you are trying to have a biological child.

Can varicocele affect fertility?

Yes, varicocele can affect fertility in some people. Varicocele may contribute to approximately 40% of cases of male infertility. However, many people with varicocele have no problems conceiving.

Medical experts do not understand what role varicocele plays in infertility. It’s possible that the temperature inside your scrotum may increase due to a buildup of blood in the veins. A high temperature affecting both testicles can affect sperm count or production.

Talk to a health care provider if you suspect you have infertility. Fertility concerns are the main reason people seek varicocele treatment.

What are the symptoms of varicocele?

Varicocele usually has no symptoms. However, you may notice the following symptoms:-

1. Mild pain in the testicles or pain in the scrotum, which often gets better when lying down.

2. Swelling in your testicles or scrotum.

3. Shrinkage of your testicles (testicular atrophy).

4. Inability to conceive after at least one year of trying (infertility).

5. A small lump above your affected testicle.

What does a varicocele feel like?

Large varicoceles may feel or look like a worm or a bag of spaghetti. These may cause mild discomfort, pain or ache. Small varicoceles may be too small to see or feel.

What are the main causes of varicocele?

Healthcare providers and medical experts are not sure what causes a varicocele to develop. Some people think that a faulty “switch” (valve) inside certain veins in the spermatic cord may cause them. The spermatic cord is a band of tissue that holds your testicle in place. These veins return blood from your testicles to your body. The valve acts as a type of “on/off” switch. It contains two flap-like structures that help blood flow back toward your heart. When the valve doesn’t work the way it should, blood can pool inside the veins in your testicles. Veins become swollen over time.

Who does varicocele affect?

Varicocele can affect anyone with testicles at any age. Healthcare providers believe that many varicoceles are present at birth (congenital). People often notice varicoceles during adolescence. Medical experts suspect it may be related to puberty, when blood flow to your genitals increases. In some cases, varicocele may prevent your testicles from growing properly.

Does varicocele cause erectile dysfunction?

There isn’t enough research to say definitively that varicocele causes erectile dysfunction (ED), but there may be a link. Some studies suggest that men who receive varicocele treatment may still occasionally fail to achieve an erection, but this does not happen often.

Are there other complications of varicocele?

Large varicoceles may increase the risk of other complications, including:

1. Low testosterone (male hypogonadism) :- Men make testosterone in their testicles. Testosterone is a hormone that initiates male characteristics during puberty, increases libido (sex drive) and builds bones. And helps strengthen muscles. Low testosterone can shrink your testicles, reduce your sex drive, lose your muscle mass, and cause depression.

2. Azoospermia:- Azoospermia occurs when there is no sperm in your ejaculate (semen). Sperm cells are reproductive cells that fertilize an egg cell (ovum). From this an embryo is formed which later develops and becomes a fetus. Azoospermia is a cause of male infertility.

How is varicocele diagnosed?

A healthcare provider can diagnose varicocele. They will review your medical history, ask questions about your symptoms, and perform a physical examination.

During the physical examination, your doctor may ask you to stand up, take a deep breath, hold your nose and mouth closed, and apply pressure to expel air. This is the Valsalva maneuver. They will feel your scrotum for enlarged veins while you are holding your breath and straining.

They may also order the following tests to confirm their diagnosis:

1. Pelvic ultrasound :- Pelvic ultrasound is a non-invasive imaging test that gives your provider a detailed view of the veins in your testicles. This is the most common imaging test that providers order to help diagnose varicocele.

2. Semen analysis :- During semen analysis, you will masturbate into a special container. Your provider will then send your semen sample to a laboratory, where technicians will check the presence and overall health of the sperm. If there is concern that a varicocele is affecting your fertility, the provider will order a semen analysis.

3. Blood test: During a blood test, your provider will use a small needle to withdraw a small blood sample. They will send your blood sample to a laboratory, where technicians will check hormone levels, including follicle-stimulating hormone (FSH) and testosterone.

After confirming the presence of varicocele, your doctor will grade its severity.

What are the grades of varicocele?

Healthcare providers use grades to detect and score varicocele;-

1. Grade 0 – This is the smallest type of varicocele. Your provider can’t feel it during a physical exam, but they can see it on an ultrasound.

2. Grade I – Your doctor can’t see the varicocele, and they can only feel it if you do the Valsalva maneuver.

3. Grade II – Your doctor can feel the varicocele even when you are not doing the Valsalva maneuver, but it is still not visible.

4. Grade III – This is the largest varicocele. Your doctor can see and feel it clearly.

How do you get rid of varicocele?

Treatment of varicocele depends on the severity of your varicocele. For low-grade varicocele, a healthcare provider may recommend home treatment options, including:

1. No need for treatment:- If your varicocele does not bother you or cause fertility problems, you will not need treatment.

2. Change in your routine:- You may need to avoid certain activities that cause discomfort. Wearing tight-fitting underwear (such as spandex or elastane) or a jockstrap while exercising or standing for long periods of time may relieve symptoms.

3. Ice:- Applying ice or a cold compress on your scrotum can provide relief from pain and discomfort. Do not apply ice directly to your skin. Wrap ice or a cold pack in a towel. Do not apply ice for more than 15 minutes at a time.

4. Over-the-counter medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) – such as naproxen and ibuprofen – can help relieve any aches or pains in your scrotum or testicles. . Not everyone can take NSAIDs, so it’s a good idea to talk to a provider before taking them.

What is varicocele surgery?

Varicocelectomy is a surgical procedure that treats severe varicoceles that are painful or affect your fertility. A surgeon who specializes in conditions affecting your urinary system and reproductive system will cut your affected veins and seal the ends. This redirects blood flow to other healthy veins in your scrotum.

How long does it take to recover from varicocele treatment?

Most people recover completely within six weeks after varicocelectomy.

What happens if varicocele is left untreated? What happens if varicocele is not treated?

It depends on the varicocele grade. If you have a small varicocele that doesn’t bother you or cause fertility problems, your healthcare provider may not recommend treatment.

If you have a high-grade varicocele and you don’t get treated, it can permanently damage your testicles.

Can varicocele be prevented?

Medical experts are not sure what causes varicocele to develop. As a result, they’re not sure how you can stop them.

Note, do not take any medicine without doctor’s advice. Self-medication is life-threatening and can lead to serious medical conditions.