This is an abbreviated version of the complete article.*
Basic Facts
Varicoceles are varicose veins in the scrotum.
Up to 80 percent of men evaluated for infertility have a varicocele.
Image-guided interventional radiologic or surgical treatments can reduce or remove varicoceles, relieving pain and potentially improving fertility.
A varicocele is a varicose (dilated, or swollen) vein in the scrotum.
Varicoceles occur in approximately 15 percent of men and can cause pain, swelling, and even infertility. Most men who experience varicoceles are between the ages of 15 and 35.
A varicocele is a swollen vein in the scrotum.
Physicians aren't certain why varicoceles cause infertility. One theory is that varicose veins increase the amount of blood in the scrotum, which heats the testicles so that sperm production decreases.
WHAT ARE THE SYMPTOMS?
Symptoms of varicoceles may include:
Discomfort;
Testicular atrophy;
Swelling; and
Fertility problems.
Many men, however, experience no symptoms from varicoceles. A physician often discovers them during a routine physical examination or a fertility workup.
CAUSES AND RISK FACTORS
Poorly functioning valves in the veins that provide the outflow for testicular blood typically cause varicoceles. Rarely, problems with the blood vessels in the kidneys can cause varicoceles.
DIAGNOSIS
To diagnose varicoceles, the physician will perform a physical examination, which includes examining the testicles. Typically, the physician can feel but not see the varicocele. In severe cases, the varicocele may be visible.
After the physical examination, the physician will perform one or more of the following tests:
Doppler stethoscope;
Doppler ultrasound; or
Venography.
TREATMENT APPROACH
To relieve any discomfort, the man may wear an athletic supporter or snug underwear to support the scrotum or take nonsteroidal anti-inflammatory medications (NSAIDs, such as ibuprofen).
Treatment for varicoceles is indicated if a varicocele:
Is associated with infertility;
Causes pain;
Recurs after treatment; or
Occurs in childhood or adolescence.
Varicoceles can be removed using a minimally invasive interventional radiologic image-guided approach called varicocele embolization, or with surgery.
In varicocele embolization, the physician places a metal coil or other object in the varicocele using a catheter (a long, thin tube) inserted in a blood vessel in the groin. The procedure takes less than 2 hours and is done under local anesthesia on an outpatient basis.
Surgery for varicoceles, called a varicocelectomy, involves tying off the varicocele to shift the flow of blood into healthy veins. This outpatient procedure may require general or spinal anesthesia.
Medical Review Date: November 16, 2009
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