Varicocele is a medical condition that causes the enlargement of veins within the scrotum. These veins are similar to varicose veins that form in the legs, but instead of being outside the body, they are inside the scrotum.

Varicocele affects around 15-20% of all men, and in some cases can lead to infertility.

What Causes Varicocele?

The exact cause of varicocele is not fully understood, but it is believed to be caused by a problem with the valves inside the veins that help blood flow back towards the heart.

When the valves don’t work properly, blood pools in the veins, causing them to swell and become enlarged. Varicocele is most commonly found in the left testicle, although it can occur in both testicles.

Symptoms of Varicocele

Varicoceles are often painless and may not cause any symptoms. In some cases, a varicocele may cause discomfort or pain in the scrotum, especially after prolonged standing or physical activity. Other symptoms may include:.

A noticeable lump in the scrotum
Swelling in the scrotum
Testicles that feel heavy or achy
Enlarged veins that are visible on the surface of the scrotum

Diagnosis of Varicocele

Varicocele is usually diagnosed with a physical exam. Your doctor may ask you to stand up, take a deep breath, and then bear down (like you are having a bowel movement), to help detect any swelling in the veins.

Your doctor may also order an ultrasound to get a better look at the veins in your scrotum.

Varicocele and Male Fertility

Varicocele is considered to be a leading cause of male infertility, affecting about 40% of men with fertility problems. The exact way that varicocele affects fertility is not fully understood, but there are several theories:.

Increased Testicular Temperature – Varicocele can cause the temperature in the testicles to be several degrees higher, which can damage sperm and reduce their motility (ability to move).
Reduced Blood Flow – Blood that pools in the veins can reduce the amount of oxygen and nutrients that reach the testicles, which can also harm sperm.
Testosterone Levels – Some research has suggested that varicocele can reduce testosterone levels, which can also harm sperm.

Treating Varicocele

There are several treatment options for varicocele, including:.

Observation – If the varicocele is not causing any symptoms and does not affect fertility, your doctor may recommend just keeping an eye on it.
Surgical Repair – Varicocele can be treated with a surgical procedure called varicocelectomy, which involves tying off or closing the affected veins. This is usually done on an outpatient basis.
Embolization – Instead of surgery, your doctor may recommend embolization, which is a minimally-invasive procedure that involves blocking off the affected veins with tiny coils or plugs.

Conclusion

Varicocele is a common and treatable condition that can affect male fertility. If you are experiencing any symptoms or are having trouble conceiving, it’s important to talk to your doctor to see if varicocele is the cause.