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VARICOCELE
A Varicocele is where veins inside the scrotum enlarge. The condition is a little like varicose veins elsewhere in the body. In many cases having a Varicocele does not cause problems and does not require treatment, however sometimes Varicoceles can affect fertility by causing low sperm counts and low sperm quality.
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In some cases, the presence of a Varicocele can prevent the testes from developing properly or can cause them to shrink.
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Varicoceles often develop in childhood or during puberty, but may not diagnosed until early adulthood, or later. The condition tends to affect the left teste more than the right.
Causes
Varicoceles are believed to be associated with malfunctioning valves in the testicular veins causing problems with blood flow. This can result in blood pooling in the scrotum, which in turn causes enlargement of the veins.
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Varicocele formation may run in families, and is also associated with kidney tumours (primarily in older patients).
Symptoms
In many cases a Varicocele may be present without causing any outward symptoms at all. When symptoms are present the following can occur:
Discomfort in the scrotum, which can be acute but is more often a dull ache; the discomfort is more noticeable during exercise or when standing for long periods. This tends to become worse towards afternoon/evening and/or in hot weather.
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A noticeable swelling or lump in the affected testicle, and/or a significant difference in size between the testicles.
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Another symptom is a fertility issue, which may be found during a fertility evaluation.
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Tests / Diagnosis
The first step is a physical examination by a doctor, which involves either checking for any swelling in the scrotum (If a Varicocele is present a mass may feel like a 'bag of worms').
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If further investigation is required, this is usually via a scrotal ultrasound. More imaging may be required to rule out other causes of any lump or swelling, such as the presence of a tumour.
Treatment
Where a Varicocele is causing symptoms or impairing fertility, treatment is usually recommended. Modern practice is to treat the Varicocele by minimally invasive methods such as Embolisation.