What is a varicocele?

A varicocele (VAR-i-ko-sel) is a condition where the veins (blood vessels) in the scrotum are enlarged and dilated (widened). The scrotum is the sac that holds the testicles, which produce sperm and hormones. A varicocele is the most common cause of infertility in men as it affects how sperm is produced. Infertility means not being able to get someone pregnant. A varicocele is usually found more on the left testicle than on the right testicle.

What causes a varicocele?

A varicocele occurs when the valves (door-like stoppers) within the veins in the scrotum do not work properly. Veins are blood vessels that bring blood from your body back to your heart. Valves open and close to keep the blood flowing in one direction. The abnormal valves prevent normal blood flow and cause blood to backup, which dilates and enlarges the veins.

What are the signs and symptoms of a varicocele?

A varicocele may not have any signs or symptoms. If signs or symptoms are present, these may include any of the following:

  • Infertility.

  • Presence of a mass or swelling on the scrotum that feels like a bag of worms.

  • Veins that are enlarged, twisted, and may be seen in the scrotum.

How is a varicocele diagnosed?

Your caregiver will take a complete medical and reproductive health history from you. You may need any of the following tests:

  • Physical examination: Your caregiver will do this with you lying down and standing up. When the varicocele is not easily felt, he may ask you to do a Valsalva maneuver. This is done by pretending to exhale hard while the mouth and nostrils (nose openings) are closed. Pretending to bear down to have a bowel movement (BM) is another way to do this maneuver.

  • Semen analysis: A semen analysis is a test to check a man's fertility. A semen sample will be taken. Semen is the thick, white, sperm-containing fluid discharged during ejaculation (process of ejecting semen from the penis). You may need to talk with your caregiver about the method of sample collection.

  • Spermatic venography: This test will examine and show the position of the veins in the scrotum. During this test, your caregiver will put dye into your body and take x-rays to look for the varicocele. Tell your caregiver if you are allergic to shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye.

  • Ultrasonography: A scrotal ultrasound uses sound waves to find lumps and other changes in your testicles and scrotum.

How is a varicocele treated?

With treatment, a varicocele may be cured, and its symptoms relieved. You may have any of the following:

  • Percutaneous embolization: Percutaneous embolization uses a special tube that is inserted into a vein in either your groin or your neck. After seeing the varicocele, coils or balloons are released to create an obstruction (blockage) in the enlarged veins. This obstruction will stop blood flow and treat the varicocele.

  • Surgery: Open or laparoscopic surgery may be done to cut and tie off the veins leading to the varicocele. This stops blood flow and treats the varicocele. Open surgery for a varicocele is done by making an incision in your groin, abdomen (stomach) or below the groin. Laparoscopy is done by inserting a scope into small cuts made in your abdomen. The scope is a long tube with a magnifying glass, a camera, and a light on the end.

Where can I find more information?

Having a varicocele may be hard for you. Contact any of the following for more information:

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address:
  • American Society for Reproductive Medicine
    1209 Montgomery Highway
    Birmingham , AL 35216-2809
    Phone: 1- 205 - 978-5000
    Web Address:

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