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Conditions we treat

Varicocele

What is a varicocele?

A varicocele is a network of swollen or enlarged veins in the scrotum. Varicoceles are a common condition, presenting in 20% of men. In some cases, only minor symptoms are present, though for some men a varicocele can be extremely painful and can interfere with normal activities. Varicoceles generally form during puberty and can grow over time. A varicocele may cause problems such as low sperm production contributing to infertility.

What Causes a Varicocele?

The veins from the testicles (known as the testicular veins) pass up out of the scrotum, through the groin and up through the back of the abdomen. The left testicular vein joins the left kidney vein. The right testicular vein joins the main central vein of the abdomen (inferior vena cava). Normal veins have one-way valves which prevent the back flow of blood. A varicocele occurs when the valves in the testicular vein are leaky or absent. A backup of blood can occur, causing the veins to swell and widen.

Varicocele Symptoms and Problems

Varicoceles are more commonly found on the left side of the scrotum and often produce no signs or symptoms. If you have one, you may experience:

  • A dull ache, heavy dragging sensation or sharp pain in the testicle
  • Enlarged or twisted veins
  • Different sized testicles

Varicocele and Infertility

40% of subfertile men have a varicocele. There is a well-known association between varicocele and male subfertility. Although the exact cause is unknown it is thought to be due to increased temperature of the testes and poor blood flow. Pooling of blood in the varicocele warms the testicles, decreasing the number and quality of sperm produced.

Varicocele and Testosterone

Testosterone is the male sex hormone and is produced by cells within the testicle. There is an association between a varicocele and low testosterone. Similar to infertility, the increased testicle temperature and poor clearance of metabolites may contribute to poor testosterone production. Patients may experience low testosterone symptoms even though the varicocele is not visible on examination. Low testosterone symptoms include:

  • Erectile dysfunction
  • Low sex drive
  • Increased body fat
  • Hair loss
  • Decreased muscle mass
  • Decreased semen

Diagnosis/Investigations

Diagnosing a varicocele is usually made with physical examination and/or scrotal ultrasound. Patient’s with a varicocele can be reviewed by Dr Ryan McConnell in his consulting rooms. At this appointment, Dr McConnell will carry out an ultrasound of the scrotum to confirm the presence of the varicocele and to see if it is on one or both sides. The ultrasound is also useful to exclude other problems in the scrotum and kidneys that could explain the patient’s symptoms. At this appointment, Dr McConnell will tell you if your are suitable for varicocele embolisation and answer any questions you may have.

Varicocele Treatment Options

There are two main treatment options for a varicocele:

  1. Varicocele embolisation; or
  2. Surgery

Book an appointment and take control of your vein health.