Varicocele: Causes and Symptoms

A varicocele is an abnormality of the veins that drain blood from the testicles that results in pooling of blood in the veins that return blood from the testicles and scrotum.

Blood receives oxygen in the lungs and is then pumped out through the heart to all of the cells and organs in the body. After it releases necessary oxygen to these cells, tissues, and organs, it is called “deoxygenated blood.” It returns to the heart and lungs through thinner blood vessels known as veins. Arteries are high pressure vessels, but veins are distensible, which means blood can pool in the veins. Blood in the veins is assisted to the heart by tiny valves in the vein that prevent backflow. The veins that drain blood from the testicles travel in the spermatic cord.

Causes of varicocele

There are several possible causes for development of a varicocele. It can result from malfunction of valves in the vein, which results in accumulation of blood. Other causes may be due to anatomic differences between the right and left internal spermatic veins, which supply the testicles. The left vein is longer compared to the right, so additional pressure may be required to help blood move through this vein on the way back to the heart. Finally, another cause of varicocele may be compression of the left renal vein, which brings blood back to the heart from the left kidney. When it is compressed, pressure increases and the vein may become distended.

Symptoms of varicocele

Some men will not have any symptoms of varicocele, but may notice a lump near the testicle or swelling in the scrotum. Other men may have visible veins that appear enlarged and twisted, sometimes described as a “bag of worms.”

Always seek professional diagnosis for testicular problems

Varicocele is common, occurring in approximately 15% of the male population.

Men who notice any lumpiness or swelling in the testicle should always seek immediate evaluation by a physician, both to determine whether or not the problem is the result of varicocele and to be certain the lump is not the result of an even more serious condition, like torsion or cancer. Varicocele can impact fertility. Thirty-five percent of men with primary infertility have varicocele, but up to 81% of men with secondary fertility (those who have conceived at least once before experiencing difficulty conceiving again) have varicocele.