A varicocele is an abnormal enlargement of a vein found within the scrotum of a man.
Varicoceles can be described as being similar to varicose veins. Some varicoceles can cause low sperm production, as well as poor sperm quality and infertility. They can also cause the testicles to develop abnormally or shrink.
This problem is caused by inefficient valves in the veins in the spermatic chord. The blood cannot quickly circulate through the scrotum and begins to collect in the vein causing it to expand.
A varicocele will not always cause symptoms. However, some patients experience swelling in the scrotum, a lump in a testicle, veins that are twisted or enlarged within the scrotum, and a recurring dull pain within the scrotum.
Pain that is caused by a varicocele can vary from dull to sharp, and the pain could also increase when physically exerting yourself or standing, particularly over extended periods of time. The pain could also become worse over the course of the day, and it may be relieved once you lie down on your back.
Varicoceles are caused when the testicular vein, which is responsible for draining the scrotum and testicles of blood, becomes dilated, leading to abnormally large blood vessels throughout one side of the scrotum.
All veins throughout the body have a one-way valve which enables blood to flow from an organ towards the heart, and not the opposite way. If these valves fail, sometimes blood can pool in the surrounding blood vessels. This is particularly noticeable in the scrotum because the effects of gravity enhance the pooling effect. The result is that the blood vessels become particularly large and prominent.
On rare occasions, varicoceles can occur not as a result of defective valves in the veins, but from high pressure. Most commonly, this high pressure is caused by a growth in the abdomen or from swollen lymph nodes. This cause of varicocele is usually only found in men over the age of 45 and is very rare. When it does occur, it usually causes the swelling to occur very suddenly and is often accompanied with intense pain, unlike varicoceles which are caused by defective valves.
Varicoceles may not require any treatment, especially if they are not causing any symptoms. In cases where there are symptoms, such as pain, infertility, or testicular atrophy, however, varicocele repair procedures are an option.
Surgery can be used to seal off affected veins in order to redirect the flow of blood into veins that are normal and healthy. Repair procedures for varicoceles include open surgery, percutaneous embolization, and laparoscopic surgery.
It is not possible to prevent varicoceles; unfortunately some men are simply more likely to develop the condition than others. However, it may be possible to prevent the discomfort that is associated with them by wearing tighter, more supportive underwear.
Typically, the pain associated with varicocele is relatively mild, and more of a dull, aching sensation than an acute pain. This can often worsen throughout the day, particularly in those who stand for long periods of time. This is due to the effects of gravity; it causes more and more blood to pool in the blood vessels throughout the day. Taking frequent breaks to sit or lie down may help to reduce the pooling and prevent discomfort.