What is it?
This is a benign condition. It is an abnormal dilatation of the veins of the testicles. This is similar to varicose veins in the legs. It may cause no symptoms and you may not even be aware of its presence. However it may cause pain in the scrotum. It may be present on one side or on both sides.
How will I be assessed?
You will be seen by a Urologist who will take a history and then examine the scrotum. The diagnosis is usually made by taking a history and examining you by a Urologist. The size of the varicocele is usually graded by your Urologist into grade 1-3 with grade 3 being the biggest varicocele. The diagnosis is usually further confirmed with an Ultrasound scan which will also look for other abnormalities in the scrotum. As a varicocele can be associated with kidney problems, your kidneys will usually also be scanned. Occasionally, a varicocele may be found at the time of investigating causes for difficulties conceiving a child (see information leaflet on male factor infertility).
What else might it be?
- Cyst
- Infection
- Hernia
- Hydrocele
- Cancer
Do I need treatment?
No. Treatment is only advised if the varicocele is causing you pain or discomfort. It may also be recommended if you are having problems conceiving a child or have a small testicle on the affected side.
What are the treatment options?
- Do nothing
- Radiological embolization (use of x-ray doctors to block off testicle veins)
- Surgery
What are the surgical options?
- Laparoscopic (key hole)
- Open
- Microscopic
What does surgery involve?
The procedure will be performed under a general anaesthesia. A cut will be made in the either in the abdomen (key hole) or in the groin. A microscope may be used which allows for a smaller incision and may result in more successful outcomes and less complications. Once the incision(s) is made, the abnormal veins will be tied off and the cut(s) closed with absorbable stitches.
How long will I be in hospital?
You will normally go home the same day.
What can I expect after discharge?
It is normal to experience swelling and pain within the scrotum. This usually settles but you may require simple pain killers. We would advise you to avoid heavy lifting and strenuous activities for at least 6 weeks. Supportive underwear may be helpful. The stitches will be dissolvable so will usually fall out by themselves over 4-6 weeks. The testicle will feel bulkier after the surgery.
What are the possible complications?
- Swelling, bruising and discomfort around the scrotum
- Bleeding and collection of blood within the scrotum (haematoma)
- Infection needing antibiotics
- Recurrence of the varicocele
- Chronic pain or non-resolution of the pain
- Hydrocele (see section on hydrocele)
- Scrotum may feel unchanged
- Shrinkage of the testis
