Varicoceles are a relatively common condition (affecting approximately 10 percent of men) that tends to occur in young men, usually during the second or third decade of life.
What is a Varicocele?
Normally, blood flows to the testicles through an artery, and flows out via a network of tiny veins that drain into a long vein that goes up through the abdomen. The direction of blood flow in this vein should always be up, toward the heart. A series of one-way valves in the vein prevent the reverse flow of blood back to the testicles.
However, these valves can fail. The reverse flow of blood stretches and enlarges the tiny veins around the testicle to form a varicocele, a tangled network of blood vessels, or varicose veins (Figure 1).
The majority of varicoceles are harmless and do not require any treatment, however treatment may be necessary if the varicocele causes any of the following symptoms:
Like varicose veins in the legs, a varicocele can cause an aching pain when the individual has been standing or sitting for an extended time and pressure builds up in the affected veins. Heavy lifting may make symptoms worse and, in some cases, can cause varicoceles to form.
There is an association between varicoceles and infertility or subfertility, but it is difficult to be certain if a varicocele is the cause of fertility problems in any one case. In one study, as many as 40 percent of men who were subfertile were found to have a varicocele. Varicoceles have been associated with a decreased sperm count; decreased motility, or movement, of sperm; and an increase in the number of deformed sperm.
It is not known for sure how varicoceles contribute to these problems, but a common theory is that the condition raises the temperature of the testicles and affects sperm production. Studies have shown that from 50 to 70 percent of men with fertility problems will have a significant improvement in the quality and/or quantity of sperm production after they have undergone varicocele repair.
Atrophy, or shrinking, of the testicles is often associated with varicoceles. The condition is often diagnosed in adolescent boys during a sports physical exam. When the affected testicle is smaller than the other, repair of the variocele is often recommended. The repaired testicle will return to normal size in many cases.
Diagnosing and Treating Varicoceles
Learn more about diagnosing and treating varicoceles, including the latest technique called Varicocele Embolization.
To learn more, visit www.virchicago.com or www.varicoceles.com.