A varicocele often causes no symptoms and, in such cases, usually requires no treatment.
This article looks at the symptoms, causes, diagnosis, and treatment of varicocele.
It also describes the available surgical and non-surgical options when treatment is indicated.
mihailomilovanovic / Getty Images
mihailomilovanovic / Getty Images
Types of Varicoceles
A varicocele specifically involves a structure called thepampiniform venous plexus.
There are right spermatic veins and left spermatic veins.
The right spermatic veins drain into the rightrenal vein(which receives oxygen-depleted blood from the kidneys).
This bend makes them vulnerable to blood flow restriction, rather like a cinch in a garden hose.
An isolated right-sided varicocele is far less common, accounting for only around 2% of cases.
Bilateral (two-sided) varicoceles can also occur, albeit less commonly than a left-sided varicocele.
Symptoms of a Varicocele
A varicocele is typicallyasymptomatic(meaning without symptoms).
Varicoceles and Infertility
A varicocele causes the pooling of blood in veins that service a testicle.
It tends to develop gradually over time.
How a Varicoceles Occurs
A varicocele is because of the failure of valves within the spermatic veins.
These valves help regulate the flow of blood through the vein, mostly by preventing the backflow of blood.
If the valves are damaged or defective, blood can start to pool, leading to varicocele.
The exam is done while you are standing.
Doing so can help reveal the varicocele.
Treatment
Once a varicocele is present, it will not go away on its own.
This doesn’t mean that it is necessarily problematic or in need of treatment.
If there are no symptoms and your fertility is not impaired, a varicocele is often left untreated.
If pain is the only concern, conservative treatment is recommended before more invasive procedures are considered.
If testosterone is low, this can be raised by conservative measures or with medication.
These can occur with all three procedures but are less common with microsurgical varicocelectomy.
Some studies suggest that all three techniques are similarly effective in improving conception rates.
The condition is often asymptomatic but can cause pain and infertility in some people.
A varicocele is diagnosed with a physical exam and occasionally an ultrasound.
Frequently Asked Questions
Not really.
Of the available treatment options, microscopic varicocelectomy may offer better results and lower rates of varicocele recurrence.
Muscle mass, sex drive, and sperm count may also be reduced in later life.
Baigorri BF, Dixon RG:Varicocele: a review.Semin Intervent Radiol.
2021;4(4):CD000479.
