Varicocele

A varicocele is an enlargement of the veins inside the scrotum (the pouch that contains the testicles). It's similar to varicose veins that can appear in the legs.

It happens when blood doesn't flow properly and pools in the veins, causing swelling and sometimes discomfort.

📍 Who can get a varicocele?

Affects about 1 in 6 men.
Most common between ages 15 and 25.
It can affect fertility, but not always.

⚠️ What are the symptoms?

Many men have no symptoms and discover it by chance. When symptoms are present, they may include:

A feeling of heaviness or discomfort in the scrotum.
A dull ache, worse when standing or after physical activity.
Visible or palpable veins, like a "bag of worms".
Shrinking of the affected testicle.
Fertility issues (poor sperm quality).

🧪 How is it diagnosed?

Urological exam: the doctor feels the scrotum, sometimes while you strain (Valsalva maneuver).
Doppler ultrasound: a non-invasive test that shows blood flow and confirms vein dilation.
Semen analysis: helpful if there are concerns about fertility.

💬 Does varicocele always need treatment?

No. It's only treated if:

It causes pain or discomfort.
There is a difference in testicle size.
Semen quality is affected.
There are fertility problems in the couple.

🛠️ How is it treated?

Available options:

Observation: if it causes no issues, regular monitoring may be enough.
Surgery (varicocelectomy): dilated veins are tied off. It's safe and effective.
Embolization: a minimally invasive procedure a radiologist performs to block off the abnormal veins from the inside.

⏳ What to expect after treatment?

Mild pain for a few days.
Return to normal activities within 1–2 weeks.
Sperm quality may improve in 3–6 months.
Sometimes, more time is needed to see fertility benefits.

👦 What about teenagers?

In adolescents, each case is assessed individually. Treatment is considered if:

One testicle is smaller than the other.
There is pain.
There are concerns about future fertility.

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