What is a varicocele?

A varicocele is a network of swollen veins in your scrotum, near your testicle. Varicocele is pronounced vari-co-seal and sometimes spelled ‘varicocoele’.

Some people say a varicocele feels like a 'bag of worms'. It usually occurs on the left side of the scrotum, but it can occur on both sides. It’s rare to have a varicocele only on the right side.

A varicocele can develop around puberty. Varicoceles are more common as you get older.

What are the symptoms of a varicocele?

You may notice a lump in your scrotum. Varicoceles can usually be felt or seen when you’re standing up.

If the varicocele is small, you might only notice it if you are upright and you:

• cough
• bear down
• strain (as though you’re trying to push out a bowel motion)

Most people don't feel any pain from a varicocele. You might feel a dull ache or 'dragging' sensation, or your testicle might feel heavy. Some people find it can be uncomfortable after:

• exercise
• standing for a long time
• at the end of the day

It usually feels better if you lie down.

You might discover you have a varicocele during a regular testicular self-examination.

Watch this video from Healthy Male to learn how to check your testicles for any changes through a self-testicular examination.

Video not working? View it here.

What causes a varicocele?

A varicocele is generally thought to be caused by a problem with the veins that drain blood from your testicles. Veins contain valves that keep blood flowing towards your heart. If these valves are not working properly, blood can leak backwards and pool in the vein. Eventually, the veins become larger than normal.

You are more likely to develop a varicocele if it runs in your family, or if you have varicose veins in your legs.

Rarely, a mass in your abdomen might cause a varicocele to develop.

When should I see my doctor?

If you have pain or notice a lump in your scrotum, it’s important to see your doctor. Your doctor will be able to check what’s causing the lump and whether it could be something serious, such as testicular cancer.

If you have a varicocele and you're worried about the possibility of fertility problems, it’s a good idea to discuss it with your partner and your doctor.

How is a varicocele diagnosed?

Your doctor will usually be able to diagnose a varicocele by examining your scrotum and testicles.

Sometimes, an ultrasound scan of your scrotum may be recommended.

In some people, a semen analysis (to assess your fertility) and a testosterone blood test may be done.

You might find out you have a varicocele if you are seeing a doctor about fertility problems.

How is is a varicocele treated?

Many people have no symptoms or complications, and do not need any active treatment. Your doctor may recommend regular follow-up appointments to check on your varicocele.

Your doctor may suggest treatment if:

• your varicocele is painful or uncomfortable
• the varicocele is making one testicle smaller than the other
• you have fertility problems

There are several procedures that can treat a varicocele. Your age and fertility will be considered when deciding on treatment options.

One treatment option is surgery to tie the swollen veins. This is usually done under general anaesthetic. It can be done through keyhole surgery.

Other options use tiny metal coils or chemicals to treat the veins that are causing the problem. They are inserted through a tiny cut made in the skin, often in your groin. These procedures are usually done under local anaesthetic and sedation. Recovery is usually quick.

Complications of varicocele

A varicocele can cause complications, including:

• reduced growth of a testicle in teenagers
• reduced testosterone production from the affected testicle
• problems with fertility

Can varicoceles be prevented?

There is no known way of preventing varicoceles.

Resources and support

Read more about varicoceles and checking your testicles at the Healthy Male website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.