A collection of varicose veins in the scrotum
A varicocele is a knot of dilated veins in the scrotum. The condition is caused by leaking valves in the testicular veins, which drain blood away from the testes, and it affects as many as 1 in 7 men. There is usually no identifiable reason for the leakage of these valves, but, in rare cases, a varicocele can result from pressure on a vein, usually in the pelvis, which prevents blood draining efficiently from the testis. This pressure may be due to a tumour in a kidney (see Kidney cancer). Varicoceles most commonly occur on the left-hand side of the scrotum.
If you develop a varicocele, you may notice some swelling of your scrotum and a dragging, aching discomfort. The affected side of your scrotum may hang lower than normal, and the swelling may feel like a bag of worms.
Your doctor will probably be able to make a diagnosis by examining your scrotum while you are standing up and again while you are lying on your back. If the swelling is caused by a varicocele, it should disappear when you lie down because the veins will empty. Small, painless varicoceles do not need to be treated because they usually cause no other symptoms and often disappear. Wearing an athletic support or close-fitting underwear can relieve mild discomfort. If the varicocele is due to a kidney tumour, all or part of the kidney will be removed surgically.
A varicocele may reduce your fertility, but sexual performance should not be affected. If tests reveal that you have a low sperm count or if you have persistent discomfort, surgery may be needed to divide and tie off the swollen veins. Varicoceles sometimes recur.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.