Varicocele – Diagnosis and Treatment
Diagnosis
Doctors often use ultrasound to spot varicoceles around the testicle and inside the scrotum. This test uses sound waves to create pictures of the spermatic cord and veins.
Ultrasound helps doctors find swelling or blocked blood flow. They use it to confirm if the veins are enlarged, rule out other causes for symptoms, and look for anything that might stop proper blood flow.
Doctors use these results to decide how to treat problems with sperm production or swelling.
A simple table shows what an ultrasound can reveal:
| What Ultrasound Checks | Why It’s Important |
|---|---|
| Enlarged veins | Confirms varicocele |
| Blood flow blockages | Finds problems affecting testicles |
| Signs of lesions or growths | Helps rule out other conditions |
Treatment
Surgical Correction
Doctors often choose surgical repair for varicocele when infertility, testicular growth delays, or long-term pain occur. The main goal is to block off the enlarged vein so blood flows through healthy vessels.
Because there are multiple vein systems in the scrotum, redirecting the blood usually does not cause other problems.
After surgery, the testicle on the affected side may start to grow at a more normal rate, especially in teenagers. Men with low sperm count may see improvement in sperm quality.
Possible Negative Effects of the Procedure
Surgical procedures to fix a varicocele generally have a low risk of serious problems. However, some side effects and complications can happen:
- Fluid Buildup (Hydrocele): Swelling or fluid may collect around the testicle.
- Recurrent Varicocele: The enlarged veins can return.
- Infection: There is a small risk of infection.
- Artery Damage: Rarely, blood vessels may be injured.
- Chronic Pain: Pain may not go away or may change after surgery.
- Hematoma: Blood may pool around the testicle.
Pain relief after surgery is not always guaranteed. Not all testicular pain is caused by a varicocele.
When doctors perform surgery only for pain management, relief may be limited. Pain could stay the same or, in some cases, worsen or change.
Types of Surgical Repair
The most commonly used surgical techniques to treat varicocele are:
| Surgery Type | Main Steps | Typical Duration | Anesthesia | Hospital Stay |
|---|---|---|---|---|
| Microscopic varicocelectomy | Doctor makes a small cut in the groin and ties off affected veins using a microscope for accuracy. | 2–3 hours | General | Go home same day |
| Laparoscopic varicocelectomy | Doctor makes several tiny cuts in the lower belly and uses a camera and thin tools to close off veins above the groin. | 30–40 minutes | General | Go home same day |
Doctors perform both procedures at a hospital or surgical center. After the operation, patients stay for a few hours and then usually go home.
What to Expect During Healing
Most people feel mild to moderate pain for a few days to several weeks after surgery. Doctors may prescribe pain medicine at first, then recommend over-the-counter painkillers like acetaminophen or ibuprofen.
Typical timelines for returning to normal routines:
- Return to work: Usually after 1 week.
- Exercise: Usually after 2 weeks.
Doctors will give guidance about when to resume sexual activity based on recovery. The length of recovery can vary. Following post-operative instructions and avoiding strenuous activities helps reduce complications.
Minimally Invasive Approach
Some people choose a less invasive option called embolization instead of traditional surgery. In this treatment, a specialist blocks off the problematic vein without open surgery.
A specialist inserts a thin tube into a vein in the groin or neck using local anesthesia. The tube is guided by imaging to the veins in the scrotum.
The specialist releases tiny coils or a special solution to create a blockage, which forces blood to reroute into healthy veins.
Key points about embolization:
- The procedure usually takes about an hour.
- Pain during and after the procedure is usually mild.
- Most people return to work in 1–2 days.
- Physical activity can restart in about a week.
Comparison Table: Embolization vs Surgery
| Feature | Embolization | Surgical Repair |
|---|---|---|
| Invasiveness | Minimally invasive | Invasive (incisions) |
| Anesthesia | Local (plus sedative) | General anesthesia |
| Hospital Stay | Outpatient | Outpatient |
| Recovery Time | 1–2 days (work), 1 week (exercise) | 1 week (work), 2 weeks (exercise) |
| Pain Level | Usually mild | Mild to moderate |
Doctors help patients decide which option is best based on their needs and health factors.
Everyday Options and At-Home Care
| Method | Purpose |
|---|---|
| Pain medicine (OTC) | Reduce pain |
| Supportive underwear/jockstrap | Support and ease discomfort |
- Over-the-counter pain relievers like acetaminophen or ibuprofen can help with mild pain.
- Snug support from briefs or an athletic supporter can make daily movement more comfortable.
Getting Ready for Your Doctor Visit
When you schedule an appointment with a urologist for scrotal pain or a possible varicocele, prepare ahead of time.
Wear supportive underwear, like snug briefs, to help with discomfort. Make a list of all medicines, vitamins, and supplements you currently use.
Keep track of details about your pain, such as when it started and where you feel it. Notice what makes the pain better or worse.
Questions to think about before the visit:
- What does the pain feel like?
- Is the pain steady or does it come and go?
- Has there been any recent injury?
- Does lying down help relieve discomfort?
Bring this information to share with your urologist.
