Male Reproductive Medicine and Surgery Program

Varicocele

Varicocele

What is a varicocele?

A varicocele is an abnormal enlargement of veins in the scrotum which drain the testicle. For anatomic reasons, it most commonly occurs on the left side but may occur on the right or on both sides. It is present in up to 15 percent of the entire male population in the US. However, it is more common in men with difficulty conceiving, in whom up to 40 percent will have a varicocele.

Symptoms

Many varicoceles are asymptomatic and will cause no problems for a man. However, they may cause scrotal or testicular discomfort classically described as heaviness or a dull ache. Varicoceles may also impair normal testicular growth and can impair sperm and testosterone production.

How do varicoceles hurt the testicle?

An area of active male reproductive health research involves determining the exact mechanisms of varicocele-induced testicular damage. We know that the testicles hang below the body because normal testicular function requires temperatures slightly cooler than the rest of the body. Normal testicular blood flow helps regulate this temperature difference. It is believed that the abnormally large veins (varicoceles) impair normal temperature regulation and elevate scrotal temperatures enough to disrupt testicular function. Other theories that also have supporting evidence suggest that oxidative damage, accumulation of toxins, and elevated pressures may also contribute to varicocele-induced injury.

Varicocele treatment

The two mainstays of treatment involve surgical and radiologic.

Surgical therapy

Surgical therapy involves ligating or tieing off all abnormal veins that drain the testicle to help restore normal blood flow. Our microsurgically-trained experts perform this surgery routinely. An operating microscope is utilized to help aid in the precise identification of veins so as to maximize efficacy and minimize complications.

Radiologic therapy

Radiologic therapy involves puncturing a large vein in the groin and then clogging off the offending scrotal veins. While only a small puncture is required, the recurrence rates can be high.

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