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What are Varicoceles?

Varicoceles are abnormal enlargements of the veins in the scrotum. It is commonly found in adolescent boys in puberty, and occurs mostly around the left testicle, but can also occur on both sides. Varicoceles can develop later in life, or worsen over time.

Symptoms of Varicoceles

Varicoceles may cause a sensation of heaviness or dull pain in the effected side. If significant, they can cause atrophy (shrinking) of the effected testicle or decreased fertility.

Diagnosis of Varicoceles

The condition is often detected during a routine physical examination. In men desiring fertility, a sperm count may also be performed. Ultrasound is typically not required as part of the workup of varicoceles, but may be used to identify related conditions.

Treatment for Varicoceles

Varicoceles treatment may not be necessary. However, if your varicocele causes pain, stunted testicle development, or infertility you may want to undergo varicocele repair.

Repair methods include:

  • Subinguinal varicocelectommy: A small incision is made in the groin and the abnormal blood vessels are closed. Blood flow is then redirected through normal veins. This surgery is the most common treatment for symptomatic varicoceles.
  • Laparoscopic surgery: Your surgeon makes several small incisions in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele by closing the veins inside the abdomen. This can be effective for difficult disease or patients with more difficult anatomy.
  • Percutaneous embolization: A radiologist inserts a tube into a vein in your groin through which instruments can be passed. Viewing your enlarged veins on a monitor, the doctor releases coils or a solution that causes scarring to create a blockage in the testicular veins, which interrupts the blood flow and prevents the pooling of blood in the veins. This method has fallen out of favor as longer-term studies have shown a high failure rate.

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