Unfortunately, a varicocele often produces no signs or symptoms. Sometimes, you may feel a pain or discomfort. Other symptoms include:
- Aching or dragging sensation in the scrotum, groin, or inner thigh
- Visibly swollen veins
- Reduced fertility due to impaired sperm formation
- Testicular atrophy – a small testicle on one side
Over time, varicocele grow and become more noticeable. Varicoceles have sometimes been described as looking like a ‘bag of worms’, and the condition might cause a swollen testicle - usually the left side.
Knowing when it’s time to see a doctor can be tricky, since you may not have any symptoms. As such, varicoceles often require no treatment, unless you are in pain or experiencing issues with fertility.
However, a swollen testicle is never a good sign, and you should speak with your doctor immediately if you have pain or notice a change in size to your scrotum.
What Causes Varicoceles?
Similar to varicose veins, a varicocele is caused by abnormal vein valves. When leaky, these valves do not return blood back to the heart as they should and this causes a buildup of pressure and therefore swollen veins. They are commoner on the left side of the scrotum as the left testicular vein is more prone to valve problems.
What are the Risk Factors for Developing Varicoceles?
There doesn’t appear to be any significant risk factors for developing varicoceles, and the exact cause is still unclear.
How is a Varicocele Diagnosed?
Diagnosing a varicocele is usually done via a physical examination by your GP or a specialist, such as an Interventional Radiologist or Urologist.
In some cases, your doctor may perform a scrotal ultrasounds, which can help measure the spermatic veins and gives a more detailed, accurate, visual depiction of the condition.
Once diagnosed, your doctor will classify the condition with one of three grades - 1 being the smallest, and 3 being the largest. The size doesn’t necessarily affect treatment, because you may not need treatment. How you manage varicocele depends on your pain levels or infertility issues.
How to Manage and Treat Varicocele
Many men do not need treatment for their varicocele. For those who have troublesome symptoms and in particular those with potential fertility issues, management options are as follows:
- Embolisation – where special thin metal coils are used to block the abnormal veins
- Surgery – where a cut in the groin or scrotum is used to close of the abnormal veins.
Undoubtedly symptoms are best managed by an individual patient-centred approach and some men would prefer surgery and others embolisation. When you are seen in rooms by the IR specialist you can trust that you will be only offered treatment if it is thought to be your best option.
Varicocele embolisation is a non-invasive treatment option used to treat enlarged veins in a scrotum. It involves a thin tube introduced via a vein in the neck or groin and navigated to the veins inside the abdomen under x-ray guidance. Once in position special metal coils and sometimes foam is used to close the abnormal veins.
Embolisation is an excellent option if you are troubled by your varicocele but do not want surgery. It does not involve any incisions or cuts on the groin or scrotum and does not need a general or spinal anesthetic. Surgery risks damage to the tube which carries sperm from the testicle. Risks from embolisation are very rare but can include blockage of other normal blood vessels.