What is a Varicocele?
A varicocele is a condition where the veins in the scrotum become enlarged, causing the scrotum to look and feel like a “bag of worms.” It affects the left side of the scrotum in the majority of cases. A varicocele occurs when the veins that drain blood from the testicles do not function properly, leading to pooling of blood and swelling of the veins. This is similar to how varicose veins occur in the legs.
The below images show the normal veins in the scrotum, compared to the veins and external appearance of a varicocele.
What are the Symptoms of a Varicocele?
In many cases, a varicocele is painless and may go unnoticed, but in some cases, it can cause testicular pain or discomfort. If there are symptoms, then these might include the following:
- Dilated veins that can be felt and changed appearance of the scrotum, like a ‘bag of worms’
- A dull ache in the testicle(s)
- Feeling of heaviness or dragging in the scrotum
Why Does a Varicocele Occur?
A varicocele usually occurs due to the unique way blood drains from the left testicle compared to the right. The veins on the left side of the scrotum normally drain into the renal vein, whereas the veins on the right-side drain into a different vein with lower pressure. Because of this, the left-side veins have a higher pressure and can become dilated, causing a varicocele.
Factors that might contribute to a varicocele developing include:
- Increased pressure in the renal vein (sometimes called Nutcracker)
- Increased pressure in the veins due to physical activity or growth spurts
- The veins not functioning properly (faulty valves)
Is a Varicocele Dangerous?
For most children and adolescents, a varicocele is not dangerous. It is usually a benign condition, meaning it doesn’t pose a serious health threat. Many boys with varicocele experience no symptoms and do not require any treatment.
There are potential issues in the future related to fertility, which requires follow up in the future. Your surgeon will discuss this with you.
Does a Varicocele Need Treatment?
Not all cases of varicocele require treatment. If the varicocele is causing pain, then it can be treated. In some cases in adults, there may be an association with fertility issues, however, this is not definite or well understood.
In many cases, varicocele can be managed with monitoring and reassurance. Regular check-ups with your paediatric surgeon are important to ensure that the condition is not worsening.
Treatment Options for Varicocele
While often the management of a varicocele is just to monitor it over time, in some cases, a procedure may be required to fix the veins. There are different procedure options including through interventional radiology or through surgery. If this is relevant, your surgeon will discuss these options with you.
For more information about varicocele treatment options, visit our Varicocele Surgery page.
Image Gallery for Patient Consultations
Our Paediatric Surgeons may use this image set during your consultation to explain conditions and treatments.
We welcome our referrers and other health professionals in the community to use these as well.
