Overview
A varicocele is an enlargement of the veins inside the scrotum, similar to varicose veins in the legs. It is common, often harmless, and usually affects the left side. In some men it can contribute to reduced fertility or a dull aching discomfort.
Symptoms
- A dull, aching or dragging pain in the scrotum that worsens with standing or activity
- A feeling of heaviness in the testicle
- Visible or palpable enlarged, twisted veins sometimes described as a bag of worms
- One testicle appearing smaller than the other
- Swelling that lessens when lying down
- Difficulty conceiving in some cases
Causes & risk factors
- Faulty valves in the veins of the spermatic cord that allow blood to pool
- Increased pressure in the veins draining the testicle
- More common on the left side due to local venous anatomy
- Rarely, a blockage of a larger abdominal vein in older men or sudden onset cases
Treatment & self-care
Many varicoceles need no treatment and are simply monitored. When there is significant pain, shrinkage of the testicle, or a fertility concern, a clinician may discuss procedures that close off or redirect the affected veins. A sudden new varicocele, especially on the right side, should be assessed promptly. A urologist can examine you and advise whether treatment is warranted.
See a doctor urgently if
- You notice a new lump or swelling in the scrotum so it can be properly evaluated
- You have scrotal pain or heaviness that interferes with daily life
- You and your partner are having difficulty conceiving
- A varicocele appears suddenly, does not go away when lying down, or is on the right side