Sometimes a varicocele can be diagnosed during a physical examination. A large varicocele may make the scrotum look lumpy so it resembles "a bag of worms" (Figure 2).
When varicoceles are not visible, the abnormal flow of blood can often be detected with a noninvasive imaging exam called color flow ultrasound. Varicoceles also may be detected with a venogram - an X-ray in which a special dye is injected into the veins to "highlight" blood vessel abnormalities.
| A color flow ultrasound image of a prominent varicocele
Varicocele Surgery is usually performed by a urologic surgeon, or urologist under general anesthesia in an outpatient setting. Occasionally, the surgery is performed with a local anesthetic. The surgeon makes an incision above the scrotum and cuts through the layers of tissue to expose the veins in the testicles (see Figure 3).
The affected veins are ligated, or tied off, to detour the flow of blood into normal veins. Sometimes a laparoscope (a cylindrical metal scope inserted into the abdomen) is used to perform the surgery. Recovery time depends on the type of surgery, but most patients require up to six weeks before heavy lifting and other strenuous activities can be performed. Light activities may be resumed more quickly.
In recent years, a safe and effective non-surgical alternative called varicocele embolization is becoming the treatment of choice for many patients and their physicians. Learn more by using the above link.
To learn more, visit www.virchicago.com or www.varicoceles.com.