“More than pain, it’s a discomfort”: a possible symptom of varicocele

Testicular discomfort caused by varicocele is generally dull but persistent, often described as a sensation of discomfort, heaviness, or burning in the scrotal area.
Unlike other forms of sudden, sharp pain (such as in testicular torsion), varicocele-related pain tends to develop gradually and worsen under certain conditions.

Typical characteristics of varicocele pain

Dull pain: It is a deep, non-sharp, non-stabbing pain. It is often not disabling, but it can become quite bothersome, especially over time.

Feeling of heaviness or tension: Patients describe a sensation of "fullness" or "pulling" in the scrotal or inguinal area.

Worsening throughout the day: The discomfort progressively increases after standing for many hours or after physical activity, especially in warm environments. This happens because standing and exertion increase venous pressure.

Relief when lying down: The discomfort tends to improve when lying supine, as gravity helps venous drainage and reduces pressure in the dilated veins.

Usually unilateral, often on the left side: In most cases, a varicocele appears on the left side due to the anatomical structure of the left testicular venous system, which is more prone to reflux. However, it can also be bilateral.

Other associated signs

In some cases, on palpation, one may notice a soft, tortuous mass in the scrotum, often described as a "bag of worms."
This becomes more evident when standing and during straining (such as with the Valsalva maneuver).

In patients with more severe varicoceles (rare), discomfort may radiate to the root of the thigh or the groin, or be associated with a sensation of warmth, but without redness or clear inflammatory signs, which are instead typical of scrotal infections (e.g., epididymitis).

When true pain may indicate something else

It must be emphasized that not all testicular pain is caused by a varicocele.
Sudden and intense pain — especially when associated with swelling, redness, fever, or nausea — may indicate more serious conditions such as:

• Testicular torsion (urological emergency)

• Epididymitis or orchitis

• Inguinal hernia

• Testicular tumor

For this reason, a complete urological evaluation is essential, especially when symptoms are new or atypical.