A varicocele is when veins in the scrotum have become large and swollen (dilated). The condition is like varicose veins that occur in the legs.
When veins inside the spermatic cord aren't working properly, the veins can swell. The spermatic cord joins each testicle to the body. Veins in the cord normally take blood back to the heart. Tiny valves inside the veins keep the blood flowing in the right direction. Valves that don't fully close let the blood to flow slowly or pool inside the veins. This buildup of blood causes the veins to swell.
A varicocele most often occurs in the left testicle. This may be because of the angle at which blood from the scrotum enters the kidney veins. It can cause pressure to build up in the scrotum.
How to say it
The veins in the scrotum may have valve problems or missing valves. Teen boys grow so quickly that the testicles need more blood than usual. If the veins have even small problems, they may not be able to move the extra blood quick enough.
Other problems in groin anatomy may also increase the pressure inside the veins and cause swelling. In rare cases, swollen lymph nodes can block blood flow in the veins of the scrotum and cause pain.
Most boys with a varicocele don't have any symptoms. When they do occur, symptoms can include:
- Heavy feeling in the testicles that gets worse during or after exercise
- Ongoing dull ache in the scrotum
- One testicle that is smaller than the other
- Swollen blood vessels that can be felt in the scrotum
The symptoms of a varicocele can seem like other health conditions. Make sure your child sees his healthcare provider for a diagnosis.The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The physical exam will include checking the scrotum. Your child may also have an ultrasound. This is a painless imaging test that uses sound waves to make images of tissues in the body.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may be done to ease discomfort or pain. These include:
- Lying flat. Lying down flat on the back helps the blood flow in the right direction and drain from the scrotum.
- Underwear that supports the scrotum. This may be an athletic supporter or underwear briefs.
- Pain medicine. Over-the-counter medicines such as ibuprofen or acetaminophen can help lessen discomfort.
Varicoceles in teens don't usually need treatment, unless the testicle has become much smaller or your child has a lot of pain. Treatment may include surgery or another method to take out or block the vein with the varicocele. The healthcare provider may suggest surgery if the testicles are very different in size. Surgery in a teen can restore proper blood flow in the scrotum and help preserve fertility.
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.If untreated, a varicocele may lead to fertility problems later. It can affect the ability of sperm to swim to an egg (reduced sperm motility).
Call the healthcare provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- A varicocele is when veins in the scrotum have become large and swollen (dilated).
- In most cases there are no symptoms. When symptoms do occur, they can include a heavy feeling in the testicles, a dull ache in the scrotum, or one testicle that is smaller than the other.
- Treatment is needed if the testicle has become much smaller or your child has a lot of pain. Treatment may include surgery or another method to take out or block the vein with the varicocele.
- Your child can ease pain by lying flat, wearing supportive underwear, and taking pain medicine.
- If not treated, a varicocele may lead to fertility problems later. It can affect the ability of sperm to swim to an egg (reduced sperm motility).
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
May 22, 2017
The significance of clinical practice guidelines on adults: varicocele detection and management. Shridharani A. Asian Journal of Andrology. 2016;18(2):269-75.
Freeborn, Donna, PhD, CNM, FNP,Holloway, Beth Greenblatt, RN, MEd,Greenstein, Marc, DO