You've heard of varicose veins - those swollen veins that sometimes
show up in the legs. You've probably heard your grandma and her old
lady friends talking about their varicose veins and never thought
twice about them.
But hopefully you've never heard your grandma mention a varicocele,
which is also a swelling of the veins. A varicocele happens just
to guys, and you probably wouldn't want to sit around and talk about
it with your pals. That's because it occurs not in the legs but
in a place a bit more private and a lot more tender - the scrotum.
It's generally harmless and basically the same kind of thing as
varicose veins in the legs. But what exactly is a varicocele and
how do you get rid of it?
What Is a Varicocele?
In all guys, there's a structure that contains arteries, veins,
nerves, and tubes - called the spermatic cord - that provides a
connection and circulates blood to and from the testicles. Veins
carry the blood flowing from the body back toward the heart, and
a bunch of valves in the veins keep the blood flowing one way and
stop it from flowing backward. In other words, the valves regulate
your blood flow and make sure everything is flowing in the right
But sometimes these valves can fail. When this happens, some of
the blood can flow in reverse. This backed-up blood can collect
in pools in the veins, which then causes the veins to stretch and
get bigger, or become swollen. This is called a varicocele (pronounced:
Who Gets Them?
Although they don't happen to every guy, varicoceles are fairly
common. They appear in about 15% of guys between 15 and 25 years
old, and they mostly occur during puberty. That's because during
puberty, the testicles grow rapidly and need more blood delivered
to them. If the valves in the veins in the scrotum aren't functioning
quite as well as they should, the veins can't handle transporting
this extra blood from the testicles. So, although most of the blood
continues to flow correctly, blood begins to back up, creating a
An interesting fact is that varicoceles occur mostly on the left
side of the scrotum. This is because a guy's body is organized so
that blood flow on that side of the scrotum is greater, so varicoceles
happen more often in the left testicle than the right. Although
it's less common, they can sometimes occur on both sides.
What Are the Signs and Symptoms?
In most cases, guys have no symptoms at all. A guy might not even
be aware that he has a varicocele. However, if there are symptoms,
they tend to occur during hot weather, after heavy exercise, or
when a guy has been standing or sitting for a long time. Signs include:
- a dull ache in the testicle(s)
- a feeling of heaviness or dragging in the scrotum
- dilated veins in the scrotum that can be felt (described as
feeling like worms or spaghetti)
- discomfort in the testicle or on that particular side of the
- the testicle is smaller on the side where the dilated veins
are (due to difference in blood flow)
What Do Doctors Do?
It's a good idea to get a testicular exam regularly, which is normally
part of a guy's regular checkup. In addition to visually checking
for any unusual lumps or bumps, the doctor generally feels the testicles
and the area around them to make sure a guy's equipment is in good
shape and there are no problems.
A testicular exam may be done while a guy is standing up so that
the scrotum is relaxed. (Some abnormalities like a varicocele can
be more easily felt in a standing position.) The doctor checks things
like the size, weight, and position of the testicles, and gently
rolls each testicle back and forth to feel for lumps or swelling.
The doctor also feels for any signs of tenderness along the epididymis,
the tube that transports sperm from the testicles.
The spermatic cord is also examined for any indication of swelling.
If the doctor suspects a varicocele, he or she might confirm suspicions
by using a stethoscope to hear the blood flowing backward through
the faulty veins or might even use an ultrasound, which can identify
malfunction of the veins and also measure blood flow.
Do Varicoceles Cause Permanent Damage?
Although there is no way to prevent a varicocele, it usually needs
no special treatment. A varicocele is usually harmless and more
than likely won't affect a guy's ability to father a child. Some
experts believe, though, that in some cases a varicocele might damage
the testicle or decrease sperm production. In those cases, a doctor
will probably recommend surgery.
What If the Doctor Finds a Varicocele?
Varicoceles are generally harmless, but if there is any pain and
swelling the doctor may prescribe an anti-inflammatory medication
to relieve it. If the varicocele is causing discomfort or aching,
wearing snug underwear (like briefs) or a jock strap for support
may bring relief. If pain is persistent and support doesn't help,
the doctor may recommend a varicocelectomy (a surgical procedure
to remove the varicocele).
A varicocelectomy is done by a urologist (pronounced: yoo-rah-luh-jist),
a doctor who specializes in urinary and genital problems. The procedure
is usually done on an outpatient basis (meaning there's no need
for an overnight stay in hospital). The patient usually undergoes
general or local anesthesia. To fix the problem, the doctor simply
ties off the affected vein to redirect the flow of blood into other
After surgery, the doctor probably will recommend that a guy wears
a scrotal support and places an ice pack on the area to bring down
any swelling. There may be discomfort in the testicle for a few
weeks, but after that, any aches and pains will go away and everything
should be back in full working order.