Varicocele

Varicocele: Causes, Symptoms, and Treatment

Varicocele is a common condition in males where the veins inside the scrotum become enlarged, much like varicose veins in the legs. These dilated veins, called the pampiniform plexus, can increase the temperature of the testicles, negatively affecting sperm production, motility, and overall fertility.

How Common is It?

• Affects 15% of all men
• Found in up to 40% of men dealing with infertility

Symptoms of Varicocele

While some men experience noticeable symptoms, many are asymptomatic and only learn about the condition during fertility evaluations.

Common symptoms include:

• Swollen or enlarged veins in the scrotum (often described as a “bag of worms”)
• Dull, aching pain in the scrotum, especially after physical activity or long periods of standing
• Testicular shrinkage (atrophy) due to long-term exposure to heat
• Infertility, including:
  • Low sperm count
  • Poor sperm motility
  • Abnormal sperm morphology

Causes of Varicocele

• Faulty valves in the veins cause blood to pool, leading to enlargement.
• Increased scrotal temperature disrupts sperm development and function.
• Hormonal imbalances, such as decreased testosterone, may impact sexual health and fertility.
• Anatomical factors, especially on the left side (where most varicoceles occur due to vein structure and pressure differences).

Varicocele Treatment Options

Varicocele Embolization (Minimally Invasive)

• Performed by an interventional radiologist
• A small coil or agent is inserted into the affected vein to block blood pooling
• Offers a quicker recovery than traditional surgery