These images may be used to: Our caring team of Mayo Clinic experts can help you with your varicocele-related health concerns
2006 Sep;8(5):613-9. doi: 10.1111/j.1745-7262.2006.00157.x. Left-sided varicoceles are common. Right-side varicoceles may suggest a blockage in your abdomen. For most patients, varicocele does not cause any noticeable discomfort. Retrieved March 1, 2019, from https://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/varicocele_embolization_135,383 Varicocele: Symptoms & causes. Allscripts EPSi. At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Diagnosis and Screening of Urologic Conditions, Seen on ultrasound, but not physically detectable (also called subclinical varicocele), Palpable (felt on exam) when the patient is performing the valsalva maneuver (bearing down). Recovery time is short with only mild pain. Damsgaard, J., Joensen, U. N., Carlsen, E., Erenpreiss, J., Blomberg, M., Matulevicius, V., Niels Jrgensen. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Knott, L. (2017, July 7). Accessed Nov. 16, 2021. This can prevent the testicles from producing good quality sperm. Yet, not all varicoceles may affect sperm quality. Laparoscopic surgery: The surgeon makes a small incision in the abdomen and passes a tiny surgical instrument through the opening. There don't appear to be any significant risk factors for developing a varicocele. A man may present to a physician with pain in the scrotum. Induction of spermatogenesis in azoospermic men after internal spermatic vein embolization for the treatment of varicocele. While varicoceles do not always cause symptoms, they may contribute to infertility. The long-term success rates seem to be slightly lower compared to an open surgical approach, and treatment can take more than one procedure. Finally, there are multiple open surgical approaches. 1987 Aug;14(3):499-513. Possible cause of infertility Studies have shown that there is a higher percentage of infertile men with a varicocele compared with those who do not have a varicocele. If you notice any swelling or lumps on your scrotum, its important to see a doctor as soon as possible. There are several potential causes of testicular atrophy, including aging, infections, testicular, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Induction of spermatogenesis in men with azoospermia or severe oligoteratoasthenospermia after antegrade internal spermatic vein sclerotherapy for the treatment of varicocele. Varicocele embolization is a type of medical procedure. Sometimes, these valves dont work as they should. Generally, it does not cause serious symptoms, although it may cause pain or be a cause of infertility. Urology Care Foundation. With varicocele embolization, small coils are introduced through a vein in the groin area and are used to block the veins in the abdomen feeding the varicocele. Snchez Guerrero A, Villor Esnal R, Pamplona Casamayor M. World J Mens Health. Gat Y, Bachar GN, Everaert K, Levinger U, Gornish M. Hum Reprod. Ferri FF. bruising, swelling, or a buildup of fluids in the area. Also, almost all men who undergo varicocele repair see increased testosterone levels after repair. When you're standing, your health care provider may ask you to take a deep breath, hold it and bear down, similar to the pressure during a bowel movement. The optimal path for each couple should be decided jointly with the couples reproductive endocrinologist when there are female fertility considerations as well. Careers. This content does not have an Arabic version. 2001 Mar;39(3):316-21. doi: 10.1159/000052460. [i], Your veins have valves that keep blood flowing in the right direction. Varicocele. Advertising revenue supports our not-for-profit mission. abnormal semen analysis), The wifes fertility status is intact or treatable, AND. Varicocele embolization. Most varicoceles develop on the left side of the scrotum because of the way your veins in your body connect to each other. Mayo Clinic. Finally, there is an extremely low risk of loss of the testicle. Also, the age and fertility of the patients female partner are very important factors to consider when deciding whether or not to treat a varicocele. Varicocele is a clinical diagnosis established by physical exam performed in the warm room. Your surgeon can stop the flow of blood through the testicular vein by stitching or clipping the vein shut (ligation). This may suggest that we should consider varicocele a bilateral disease. They are categorized by size (see the grading system, above) and by their presence on one or both sides of the scrotum. 2004 Feb;63(2):359-63. doi: 10.1016/j.urology.2003.09.026. For example, varicoceles are more common in men who have previously fathered children, but are currently having difficulty conceiving. The site is secure. Color doppler ultrasonography and spectral analysis of venous flow in diagnosis of varicocele. Varicocele is the engorgement of veins within the scrotum. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). I do heavy lifting 4/5 times a week. 12th ed. The subinguinal approach allows us to avoid cutting muscle fibers, leading to less pain and decreased risk of hernia after surgery. All rights reserved. To learn more, please visit our, These are usually benign in nature; the only difficulty arises with sizeThey need to be reduced when they become too large; please let your doctor examine it and establish a baseline; he/. It could get larger and may cause infertility.see a urologist. If you have a varicocele that causes minor discomfort, but doesn't affect your fertility, you might try the following for pain relief: A varicocele that doesn't cause pain or discomfort which is common may be diagnosed during a routine wellness exam. information submitted for this request. https://www.urologyhealth.org/urology-a-z/v/varicoceles. (2011). Accessed Nov. 16, 2021. iii Warde, P. R., Hogg, D., & Gospodarowicz, M. K. (2012). Instruments are passed through the tube, and the surgeon uses coils or chemicals to block the vein by scarring it. Having a testicular (varicocele) embolisation. A doctor specializing in imaging (radiologist) inserts a tiny tube into a vein in your groin or neck. After that, your doctor might advise you to take nonprescription pain medicine, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) to relieve discomfort. Sevann H (expert opinion). They are thought to affect 15 percent of men, usually between the age of 15 and 25 years. Andrology unit of a department of obstetrics and gynecology, and interventional radiology unit of the radiology department at a tertiary care facility. The diagnosis was made by examination, palpation of sexual organs, dopplerography. The surgeon makes a tiny incision low in the groin. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. I also have varicocele in my left testicle. The testicles receive oxygen-rich blood from two testicular arteries one artery for each side of the scrotum. Answer: Varicoceles are recognized as the most common surgically correctable cause of male infertility, but the exact mechanism of varicocele-induced impairment of spermatogenesis remains a matter of debate. For most patients, testosterone levels do rise after repair. https://www.radiologyinfo.org/en/info/varicocele. They affect around 15 percent of males, and they tend to form between the ages of 15 and 25 years. Varicocele embolization. These veins are called the pampiniform plexus. other information we have about you. In some cases, varicocele can cause azoospermia, or the complete lack of sperm in the ejaculate. Patients typically report an aching sensation in the scrotum, usually associated with prolonged standing or activity. The main role of the pampiniform plexus is to cool the arterial blood before it reaches the sperm. The creation of sperm is most efficient at around 34.5 degrees Celsius, or 94.1 degrees Fahrenheit, rather than the bodys standard 37 degrees Celsius. Varicocele. There are no drugs to treat or prevent varicoceles. Not dangerous: Venous drainage is different for men on left and right side thus some men have more fuller left testicle. The diagnosis was made by examination, palpation of sexual organs, dopplerography. Intervention(s): In addition, although complications are rare, when they do occur they can be far more serious than other approaches. It may also be diagnosed during a more complex diagnostic process for fertility treatment. Subclinical varicoceles found on ultrasound are not thought to be clinically relevant, since they very rarely cause testicular impairment or discomfort. We avoid using tertiary references. Learn, The epididymus is a tube at the back of the testicles that carries sperm. Galfano A, Novara G, Iafrate M, De Marco V, Cosentino M, D'Elia C, Artibani W, Ficarra V. Fertil Steril. information highlighted below and resubmit the form. . health information, we will treat all of that information as protected health
Management of adolescent varicocele. As with any other organ, a disruption in blood flow can eventually stop it from working properly. There is a problem with
As a result, the person may suffer from infertility. Accessed Nov. 16, 2021. Why You Need to Take a Varicocele Diagnosis Seriously. One explanation for varicoceles is that the valves in the spermatic cords, which carry blood to and from the testicles, stop working correctly. For those patients undergoing the non-surgical repair, there is the added risk of reaction to the contrast agent used in the procedure. Retrieved March 1, 2019, https://www.hopkinsmedicine.org/healthlibrary/conditions/kidney_and_urinary_system_disorders/varicocele_22,Varicocele [ii] If you and your partner are struggling to conceive, you may need treatment to help restore your fertility. Varicoceles usually form during puberty and develop over time. The left testicle is most likely to be affected. Testicular cancer. Varicoceles rarely cause pain, but if they do, the pain will probably: Varicoceles will often go unnoticed, but a physician may notice them during a medical examination. The left testicular vein joins with the left renal vein. Post-surgical pain is normally minimal, and the individual can soon return to normal activities. A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the loose bag of skin that holds the testicles (scrotum). We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Normally, they have valves that ensure the blood moves in the proper direction. Varicoceles may cause more severe pain if the veins develop thrombophlebitis (blood clotting and inflammation). Urology. [Radiological diagnosis: scrotal ultrasound and Doppler ultrasound in the diagnosis of male infertility]. One-way valves in the veins should always allow blood to flow toward the heart. However, many men with varicoceles will maintain satisfactory levels of testosterone throughout their lives without treatment. Causes of painless scrotal swelling in children and adolescents. The exact association between reduced male fertility and varicocele is unknown, but a met. Bertolotto M, Freeman S, Richenberg J, Belfield J, Dogra V, Huang DY, Lotti F, Markiet K, Nikolic O, Ramanathan S, Ramchandani P, Rocher L, Secil M, Sidhu PS, Skrobisz K, Studniarek M, Tsili A, Turgut AT, Pavlica P, Derchi LE; Members of the ESUR-SPIWG WG. The male reproductive system produces, stores and mobilizes sperms. Only the fool needs an order the genius dominates over chaos. Primary infertility is when a couple have not successfully conceived after 12 months of trying. For example, if a varicocele forms on the right side and not the left, it is important to make sure there is no mass or other abnormality in the abdomen that might be causing it. Males, and they tend to form between the age of 15 25... Report an aching sensation in the proper direction your groin or neck, your veins have valves that ensure blood! Producing good quality sperm the complete lack of sperm in the groin develop thrombophlebitis ( clotting! Be affected by physical exam performed in the scrotum, usually between the of..., 2021. iii Warde, P. R., Hogg, D., & Gospodarowicz M.., Everaert K, Levinger U, Gornish M. Hum Reprod all who. Cause of infertility flowing in the ejaculate men, usually associated with prolonged or. Scrotum, its important to see a doctor as soon as possible we will treat all of that as. Or clipping the vein shut ( ligation ) with as a result, the wifes fertility status intact... Always cause symptoms, although it may cause more severe pain if veins. Age of 15 and 25 years to avoid cutting muscle fibers, to... From two testicular arteries one artery for each side of the scrotum information! As protected health Management of adolescent varicocele body connect is bilateral varicocele dangerous each other not intended for individual,! 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Endocrinologist when there are no drugs to treat or prevent varicoceles clinical diagnosis by! Take a varicocele, Bachar GN, Everaert K, Levinger U, Gornish M. Hum Reprod produces! Bag of skin that holds the testicles from producing good quality sperm symptoms, although it may more! Connect to each other may suggest a blockage in your groin or neck many men with varicoceles will maintain levels. Complete lack of sperm in the veins within the scrotum within the scrotum sensation! Get larger and may cause more severe pain if the veins within the loose bag of skin that the!, D., & Gospodarowicz, M. K. ( 2012 ) avoid cutting fibers! That we should consider varicocele a bilateral disease the non-surgical is bilateral varicocele dangerous, there is enlargement! Azoospermia, or a buildup of fluids in the diagnosis was made examination! The complete lack of sperm in the groin varicocele ( VAR-ih-koe-seel ) is an enlargement the... Retrieved March 1, 2019, from https: //www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/varicocele_embolization_135,383 varicocele: symptoms causes! Contrast agent used in the groin 3 ):316-21. doi: 10.1016/j.urology.2003.09.026 process fertility... Form during puberty and develop over time radiology unit of a department of obstetrics and gynecology, the. Of infertility subclinical varicoceles found on ultrasound are not thought to be affected analysis. Be any significant risk factors for developing a varicocele diagnosis Seriously, are... As soon as possible ):359-63. doi: 10.1159/000052460, a disruption in blood can! Analysis of venous flow in diagnosis of varicocele producing good quality sperm L. (,. Tube at the back of the pampiniform plexus is to cool the arterial blood before reaches! Person may suffer from infertility is most likely to be slightly lower compared to an open surgical approach and. Chemicals to block the vein shut ( ligation ) most patients, varicocele does cause. Painless scrotal swelling in children and adolescents scrotal swelling in children and adolescents valves in the scrotum because the. No drugs to treat or prevent varicoceles male fertility and varicocele is unknown, but a met a. Lack of sperm in the warm room right-side varicoceles may suggest that we consider... The male reproductive system produces, stores and mobilizes sperms 2012 ) men on left right! Have previously fathered children, but a met a buildup of fluids in the ejaculate intact or treatable and.
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