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Varicocele (Swollen Veins Around Testicle)

What is a varicocele?

A varicocele is a group of swollen veins around one or both testicles. The testicles are part of the male reproductive organs. They are in a sac of loose skin, called the scrotum, which is below and behind the penis. The testicles make sperm and the male hormone, testosterone.

A varicocele can be felt through the skin of the scrotum. Each swollen vein is about the size of a thin straw.

Varicoceles are usually first found during the teenage years, but they occasionally happen before puberty.

Most varicoceles don’t cause problems and no treatment is needed. However, sometimes a varicocele can cause the testicles to shrink, which can affect the functioning of the testicles. About 40% of men with fertility problems have a varicocele. Doctors aren’t sure how the varicocele might affect a man’s ability to have a child. Some think that the blood in the swollen veins may keep the testicle too warm, which can lower the sperm count and movement of the sperm.

What is the cause?

Doctors think that the enlarged blood vessels are caused by blood that isn’t flowing properly in the veins around the testicles. This may happen because valves in the veins that should be keeping the blood flowing in one direction are not working properly. As a result, the blood backs up and causes the veins to get wider.

A varicocele is more common in the left testicle than the right. This is because of differences in the way blood flows from this side of the body towards the heart.

What are the symptoms?

Often there are no symptoms. Sometimes however, the testicle may have a dull, achy feeling. There may be some painful swelling.

Symptoms may develop gradually, long after the varicocele is first discovered. The varicocele will usually get bigger when your son holds his breath and bears down. It will normally collapse when he lies down.

How is it diagnosed?

A varicocele is usually noticed by your healthcare provider during a routine checkup.

A varicocele found only on the right side is very uncommon. In this case, some tests may be done to make sure there is not another reason for the problem.

How is it treated?

Usually it doesn’t need any treatment, but surgery to repair the veins may be recommended if:

  • The varicocele causes a lot of discomfort that does not get better.
  • The varicocele is very large and may damage the testicle.

The purpose of surgery is to seal off the veins with poor blood flow and redirect the blood flow into other, normal veins.

Surgery may be helpful for fertility problems, and may help prevent damage or shrinking of the testicles for some men.

How can I take care of my child?

If your child has pain or swelling, your healthcare provider may recommend anti-inflammatory medicine. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason. Also, check with your healthcare provider before you give medicine that contains aspirin or salicylates to a child or teen because of the risk for a serious illness called Reye's syndrome.

Discomfort or aching may also be helped if your child avoids heavy lifting and wears tight underwear or a jock strap for support.

Ask your healthcare provider what symptoms or problems you should watch for and what to do if your child has them.

Written by Robert M. Brayden, MD, Professor of Clinical Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2018.1 published by Change Healthcare.
Last modified: 2015-05-28
Last reviewed: 2017-04-11
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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