Overview

Varicocele is a condition in which veins within the scrotum, the pouch of skin that holds the testicles, become enlarged. It develops when blood does not flow efficiently through these veins and begins to collect in them. A varicocele commonly occurs on the left side and may develop during puberty.

Many varicoceles do not cause symptoms or require treatment. However, some may lead to discomfort, changes in testicular development or problems with sperm production. For these patients, varicocele treatment may involve observation, symptom management, varicocelectomy or varicocele embolisation, depending on the clinical findings.

At Sarvodaya Hospital, patients seeking guidance about varicocele and male infertility can consult a qualified urology specialist for assessment and personalised advice, subject to the services available at the treating location. The treatment decision depends on symptoms, examination findings, fertility goals and overall health.

Symptoms of Varicocele

• An aching sensation may develop after standing for long periods or physical activity.
• Enlarged veins may feel like a cluster of soft, twisted veins above the testicle.
• Some people experience a feeling of weight or dragging discomfort.
• Larger varicoceles may be noticeable through the skin of the scrotum.
• The affected testicle may be smaller than the other, particularly in adolescents.
• Some varicoceles are associated with changes in sperm count, movement or quality.

Causes of Varicocele

• Faulty Vein Valves
• Differences in Vein Anatomy
• Development During Puberty

Diagnosis of Varicocele

Varicocele diagnosis usually begins with a medical history and physical examination. Additional tests may be recommended to confirm the diagnosis, assess testicular size or investigate fertility concerns.

• Physical Examination: A urologist examines the scrotum while the patient is standing and lying down. The doctor may ask the patient to bear down briefly, a technique known as the Valsalva manoeuvre, to make enlarged veins easier to identify.
• Scrotal Doppler Ultrasound: A scrotal ultrasound uses sound waves to examine the testicles and surrounding structures. Doppler ultrasound can assess blood flow and help identify enlarged veins or abnormal backward blood flow.
• Semen Analysis: For adults undergoing fertility assessment, semen analysis measures factors such as sperm concentration, movement and shape. The results can help determine whether a varicocele may be contributing to fertility difficulties.
• Hormone Tests: Blood tests measuring reproductive hormones may be considered when there are concerns about sperm production or other signs of hormonal problems.

Benefits of Timely Varicocele Assessment and Treatment

• Relieve persistent discomfort associated with varicocele
• Support normal testicular growth and development
• Potentially improve semen quality in suitable cases
• Help identify and manage fertility-related concerns
• Distinguish varicocele from other causes of testicular pain or swelling
• Guide appropriate treatment and follow-up planning
• Support informed decisions about reproductive health
• Reduce the risk of complications through timely specialist care

Complications if Left Untreated

• Persistent or recurring testicular discomfort.
• Reduced growth or a difference in the size of the affected testicle.
• Changes in sperm concentration or movement.
• Fertility difficulties in some patients.
• Ongoing symptoms that may require reassessment.

Prevention and Lifestyle Modifications

• Use supportive underwear: Supportive briefs may reduce discomfort for some people.
• Avoid activities that worsen pain: Discuss persistent or activity-related pain with a doctor rather than relying on long-term activity restriction.
• Attend recommended follow-ups: Monitoring can help identify changes in symptoms or testicular size.
• Seek advice for fertility concerns: A specialist can determine whether semen analysis or other tests are appropriate.
• Avoid self-medication: Do not use medicines or supplements claiming to cure varicocele without medical advice.

When Should You See a Doctor?

• Consult a doctor if you notice enlarged veins in the scrotum or persistent testicular discomfort.
• Seek medical advice for testicular swelling or a noticeable difference in testicular size.
• Consult a urologist if you have fertility concerns or a diagnosed varicocele.
• Arrange a medical assessment if symptoms worsen, or you notice a new scrotal lump.
• Seek urgent medical attention for sudden or severe testicular pain, especially with swelling, nausea or vomiting.

Pre- and Post-Treatment Care

Pre-Treatment

Before recommending varicocele repair or embolisation, the medical team may:

• Review symptoms, medical history and fertility concerns.
• Perform a physical examination and arrange an ultrasound if required.
• Review semen analysis results when fertility is a concern.
• Assess current medicines, allergies and other health conditions.
• Explain the proposed procedure, potential benefits and risks.
• Provide instructions about fasting, medicines and preparation when necessary.

Post-Treatment

• Keeping the incision or catheter entry site clean and following wound-care instructions.
• Taking prescribed medicines as directed.
• Avoiding strenuous activity and heavy lifting for the period recommended by the treating team.
• Attending follow-up appointments to assess recovery.
• Reporting increasing pain, fever, significant swelling or changes at the treatment site.
• Completing repeat semen analysis when treatment was performed for fertility concerns.