A varicocele is the blow-up of veins within the baggy skin that holds your scrotum (testicles).

Varicocele is responsible for low sperm production and inferior sperm quality, which causes male infertility. Varicocele also can be the reason for the testicles to under-develop normally or cause shrink.


A varicocele often produces no signs or symptoms. Rarely, it might cause pain. The pain may:

• Vary from sharp to dull discomfort

• Increase with too much physical exertion or standing for long periods

• Worsen over a day

• Cause impaired fertility

Over time, varicocele might have enlargement and become more noticeable. A varicocele describes as a “bag of worms.” The condition might cause a swollen testicle, therefore hinders sperm production in the testicle.

When to see a fertility doctor?

Varicocele usually has no symptoms. Varicoceles might come to notice during a fertility evaluation or a routine physical exam:

• If you find swelling or you experience pain in your testicles

• Discover a mass on your scrotum

• Notice that your testicles are different sizes

• Develop a varicocele in your youth,

• You’re having fertility problems

Contact your doctor in the above symptoms. Several conditions are responsible for testicular mass or pain, of which some require immediate treatment.


A funicle carries blood to and from your testicles. What causes varicocele is not certain. Many experts believe varicocele forms when the valves inside veins prevent the blood from flowing that causes the veins to dilate. It might hurt the testicle and result in worsened fertility.

Varicoceles often form during puberty, occur on the left side of the left testicular vein.


A varicocele might cause:

• Shrinkage of the affected testicle (atrophy). The bulk of the testicle comprises sperm-producing tubules. When damaged, the testicle shrinks and softens, therefore hinders the sperm production activity. The shrinking of testicles is unclear, but the malfunctioning valves allow blood to pool within the veins. It may result in increased pressure within the veins; exposure to toxins within the blood will cause testicular destruction.

Varicoceles might keep the local temperature in or around the testicle too high, affecting sperm formation, movement (motility) and performance.


Your doctor will conduct a physical exam, which might reveal a non-tender mass above your testicle that feels like a bag of worms. If you have a smaller varicocele, you need to stand, take a deep breath and hold it while you bear it down (Valsalva manoeuvre). It helps your doctor detect abnormal enlargement of the veins. If the physical exam does not give accurate results, your doctor might order a scrotal ultrasound. This test uses high-frequency sound waves to make precise images of structures inside your body. In some cases, further imaging requires to rule out a tumour compressing the spermatic vein.


Varicocele treatment might not be necessary. Many men with varicocele can father a child without any treatment. In case your varicocele causes pain, you have testicular atrophy or facing infertility which you consider assisted reproductive techniques, then, you might undergo varicocele treatment.

The purpose of surgery is to bolt off the affected vein and redirect the blood flow into normal veins. In infertility, the treatment of a varicocele might improve or cure infertility or improve the standard of sperm if techniques like in vitro fertilization (IVF) have opted.


• Varicocele repair presents relatively few risks, which could include:

• The build-up of fluid around the testicles (hydrocele)

• Recurrence of varicocele

• Infection

• Damage to an artery

Repair methods include

Open surgery: The affected vein is reachable through your groin (inguinal or subinguinal). The advanced surgical microscope allows the surgeon to see the treatment area better during surgery. Another is that the use of Doppler ultrasound, which helps guide the procedure.

You might be ready to return to normal, nonstrenuous activities after two days. Mild pain might continue for several days or weeks. Your doctor might prescribe pain medication for a limited period after surgery to alleviate discomfort.

Your doctor might advise you not to have sex for some time. It will take several months after surgery for improved sperm quality as it takes three months for new sperm to develop.

Open surgery using a microscope and a subinguinal approach has the highest success rates.

Laparoscopic surgery: With a tiny incision in your abdomen and passing a small instrument through the incision, your surgeon ascertains and repairs the varicocele. This procedure requires general anaesthesia.

Percutaneous embolization: A radiologist performs the insertion of a tube into a vein in your groin or neck. Viewing your enlarged veins on a monitor, the doctor releases coils or an answer that causes scarring to make a blockage within the testicular veins that interrupt the blood flow and repairs the varicocele.

Living with a varicocele

Infertility is a common complication of a varicocele. Talk to our fertility doctor if you and your partner are having problems getting pregnant. Surgery is only necessary if the varicocele is causing you pain or you are unsuccessful to have a child. Talk to our fertility doctor at GarbhaGudi IVF Centre, a leading fertility care consultant in Bangalore, about which treatment is right for you.

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