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What Is a Varicocele?

Varicocele with dilated veins compared to healthy testicle.

A varicocele is an enlarged, sometimes visible vein inside your scrotum. Your scrotum is the sac of skin that holds your testicles. These veins are part of your spermatic cord, the tube that carries sperm to your testes.

Varicoceles are very common and aren’t dangerous to your health. They affect about 15% of men. It’s more common to have a varicocele on the left side of your scrotum than on the right side. This is due to how blood flows through your testicles.

Varicocele Symptoms

A varicocele may look like a bulging vein in your scrotum. The appearance of a large vein is the only symptom in many people. Some people occasionally experience other symptoms:

  • A visible mass above your testicle

  • Different sized testicles

  •  Testicular pain, which often goes away when you lie down

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Varicocele Causes

Microscope photograph of abnormal sperm
Abnormal sperm

Researchers don’t know the exact cause of varicoceles. Experts believe varicoceles could develop when blood collects in your spermatic cord instead of circulating as it should.

Does a Varicocele Cause Infertility?

A varicocele doesn’t always cause male infertility. About 40% of men who seek fertility treatment have varicoceles. A varicocele can disrupt important processes:

  • How your body creates sperm

  • How much sperm you produce

  • How sperm moves

Can a Varicocele Cause Erectile Dysfunction?

There could be a link between varicocele and erectile dysfunction (ED). However, researchers haven’t proven that varicocele causes ED.

Varicocele Diagnosis

Your provider diagnoses varicoceles by visually examining your scrotum. You stand during this exam. This is because it’s more difficult to see varicoceles when you’re lying down.

Your provider may also use an ultrasound. This imaging test uses sound waves to measure the enlarged veins.

Varicocele Treatment

Varicocele Surgery: Varicocelectomy

Enlarged vein next to 1cm ruler
Swollen vein in the spermatic cord.
Photograph of surgical procedure showing stitches and ties in vein.
Varicocele procedure where we tie off branching veins with clips or ties.

 

 

You might need varicocele surgery if varicoceles cause certain symptoms or problems:

  • Elevated follicle-stimulating hormone levels, which can point to problems with sperm production

  • Irregularities in your semen analysis

  • Low sperm count

Preparing for Varicocelectomy

Your care team will give you specific instructions on preparing for a varicocelectomy. Typically, you will need to follow a few steps:

  • Eat as usual the evening before your procedure.

  • Stop eating and drinking by midnight.

  • Take any necessary medications the morning of surgery with only a small sip of water.

  • Wear comfortable, loose clothing

What to Expect During Varicocelectomy

You will get general anesthesia before a varicocelectomy. This means you will be asleep during the procedure. We use local anesthesia to numb the area around your groin. This helps you stay more comfortable when you wake up after surgery.

Your surgeon will take several steps during a varicocelectomy:

  1. Make a 1–2-centimeter incision (cut) in your groin.

  2. Locate your spermatic cord.

  3. Use a surgical microscope that magnifies their view. They open the outside layer of your spermatic cord.

  4. Find the enlarged vein and use clips or ties to separate it from the rest of the spermatic cord. This will block further blood flow through the irregular vein.

  5. Close your incision with stitches that dissolve as you heal. 

The procedure will take about 45–60 minutes. You can return home the same day.

Varicocele Surgery Recovery

Most people have little to no pain after varicocele surgery.

You will need to follow a few instructions in the first 24 hours after surgery:

  • Avoid driving or using heavy machinery.

  • Don’t consume a large meal or alcohol.

  • Put off making important decisions. Anesthesia can make it harder to think as clearly as usual.

Mild bruising, swelling, or pain is normal in the first several days. Most people resume their usual activities in 1–2 days. A typical recovery timeline is about one week:

  • Days 1–3: Take 800 milligrams of ibuprofen every eight hours and 650 milligrams of acetaminophen every six hours. This provides enough pain control for most people. Take any other prescribed pain medicines only as needed. You can also ice the area for 20 minutes every hour to ease pain.

  • Days 4–7: Your pain should decrease enough to continue your usual activities. You’ll need to avoid sex, masturbation, or lifting anything heavier than 15 pounds for a week. You can shower starting the day after surgery. Avoid baths for one week.

What Happens After Varicocele Surgery?

About 85–90% of men experience no further problems with varicoceles after surgery. You get a semen analysis three months after the procedure. A semen analysis checks your sperm quality.

About two-thirds of men see improvements in sperm quality after surgery. Roughly 40% of men can impregnate someone following their procedure.

Why Choose University of Utah ÐÇ¿Õ´«Ã½?

Our team includes fellowship-trained urologists and experienced advanced practice providers. We specialize in conditions that affect men’s sexual health and fertility. We create a safe, empathetic, supportive environment to discuss your needs and concerns. Our experts provide many treatments to help increase your quality of life and sexual health. 

Schedule an Appointment

Call 801-587-1454 or request an appointment online to connect with our team. You don’t need a referral to make an appointment. Our financial counselor will verify your insurance coverage and review overall costs with you.