Varicocele repair presents relatively few risks, which might include: Buildup of fluid around the testicles (hydrocele) Recurrence of varicoceles Infection Damage to an artery Chronic testicular pain Collection of blood around the testicle (hematoma) AskMayoExpert. Advertising revenue supports our not-for-profit mission. A hydrocele is a collection of fluid in the scrotum. Right-side varicoceles may suggest a blockage in your abdomen. When a valve doesnt work the way it should, blood may build up inside the veins in your testicles. Does varicocele repair improve male infertility? When a varicocele doesnt reduce, it also raises concern that there is an abdominal blockage such as a mass or tumor that could be causing the mass. All rights reserved. Varicoceles are usually painless but can sometimes cause testicular pain, which may come and go. Well explain possible causes and treatment options. WebThe present study finds that what was traditionally considered a predominantly unilateral anatomical abnormality apparently has a strikingly high bilateral prevalence (80.7%). If your job involves heavy lifting, your healthcare provider may advise that you wait longer. Cleveland Clinic is a non-profit academic medical center. If needed, a small operation can usually cure the problem. The affected testicle eventually may return to its expected size. Confirm the diagnosis or characterize the varicocele, Eliminate another condition as a possible cause of signs or symptoms, Detect a lesion or other factor obstructing blood flow, A testicle that shows delayed development, Low sperm count or other sperm irregularities (usually only tested in adults), Chronic pain not managed by pain medication. Penile melanosis is characterized by small patches of dark skin on the penis. They occur on the left side 90% of the time, but may also be bilateral (occuring on both sides). 12th ed. In: Ferri's Clinical Advisor 2022. Dec. 12, 2021. Accessed Nov. 16, 2021. Accessed Nov. 30, 2021. As a result of the closure of the affected vein, the blood flow is re-routed through healthy veins, and the varicocele disappears. Varicoceles often cause no signs or symptoms and dont usually require treatment. If you experience any of these, see your health care provider to get a timely and accurate diagnosis. While varicoceles may cause pain, most do not. A varicocele develops slowly over time. They can also affect your sperm production and sperm quality. A coil is then placed into the catheter and into the varicocele. However, many people with varicoceles experience no reproductive obstacles. Most develop for no apparent reason, are harmless and can be left alone. Surgery is generally performed when the swelling of the veins causes chronic pain or male infertility. Medical experts dont understand what role varicoceles play in infertility. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Open surgery and laparoscopic surgery are both an option as is a minimally invasive procedure called varicocele embolization. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. It can also shrink the testicles. 2014;102(6):1556-60. doi:10.1016/j.fertnstert.2014.10.007, Halpern J, Mittal S, Pereira K, Bhatia S, Ramasamy R. Percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications. WebA varicocelectomy is a surgical procedure that treats a varicocele. However, when valves in the testicular vein dont work properly, gravity can make blood collect in the scrotum, causing a varicocele. Recovery time is short with only mild pain. This condition can affect fertility. During a varicocele embolization, a vascular specialist makes a tiny incision near your groin. Most people fully recover from a varicocelectomy within six Nonacute scrotal conditions in adults. Partin AW, et al., eds. [iii]. If undergoing general anesthesia, regional anesthesia, or a form of intravenous sedation known as monitored anesthesia care (MAC), you will need a period of fasting to avoid pulmonary aspiration and choking.
Causes of a varicocele can vary. 2012;2012:1-9. doi:10.1155/2012/597495, Practice Committee of the American Society for Reproductive Medicine;Society for Male Reproduction and Urology. The pain may Change from dull to sharp Worsen as you stand or exert yourself for a long time Get worse as the day progresses Be relieved once you lie on your back What is the grading system for varicocele size? A vein abnormality in the scrotum may result in a varicocele.A varicocele is an enlargement of the veins within the scrotum. We do not endorse non-Cleveland Clinic products or services. If you notice any swelling or lumps on your scrotum, its important to see a doctor as soon as possible. You'll likely be able to return to work in 1 to 2 days and resume exercise after about a week. Do I need any tests? The evaluation of patients with scrotal pain should include scrotal ultrasonography to rule out other pathology and urine tests to rule out infection. Asian J Androl. Eyre RC. Fertility concerns are the top reason why people receive varicocele treatment. Causes of painless scrotal swelling in children and adolescents. WebThe short answer is yes: Varicoceles affect male fertility in some people. Varicoceles are common. Accessed Nov. 16, 2021. A varicocelectomy can repair a varicocele and sometimes improve your fertility. A varicocele usually occurs on the left side of the scrotum and often produces no signs or symptoms. They are categorized by size (see the grading system, above) and by their presence on one or both sides of the scrotum. They usually occur on the left side, likely related to the course of the testicular vein in the abdomen. Healthcare providers and medical experts arent sure what causes varicoceles to develop. Among them: You will need to change into a hospital gown for varicocele surgery, so wear something comfortable that you can easily get out of and back into. It may also be due to the failure of the within the pampiniform plexus that are meant to prevent the backflow of blood. Medical experts dont understand exactly what role varicoceles play in male infertility. Mayo Clinic. A hydrocele is a collection of fluid in the scrotum. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. These factors may contribute to the following complications: Mayo Clinic does not endorse companies or products. Although the cause of varicocele is not entirely clear, it is believed that the size or geometry of the veins servicing the testicles are simply inadequate in some men, likely from birth. Percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications. Varicoceles may cause more severe pain if the veins develop thrombophlebitis (blood clotting and inflammation). When varicocele surgery is done primarily to treat pain, there is a risk that the pain may worsen, or the nature of the pain may change. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Varicocele tends to affect the left testicle more than the right due to the direction of blood flow through the scrotum.
2011;59(3):455-61. doi:10.1016/j.eururo.2010.12.008. information is beneficial, we may combine your email and website usage information with If varicocele surgery is recommended, you will meet with either a urologist qualified to perform a varicocelectomy or an interventional radiologist trained to perform percutaneous embolization. (2016). The procedure lasts about an hour. Philadelphia, PA: Elsevier. Less commonly, it can affect the right side or both sides. Ask your radiologist when you can resume all activities. 12th ed. The scrotum is a skin-covered sac that holds your testicles. This is doubly true if you have undergone intravenous sedation or general anesthesia. Wearing supportive underwear or a jockstrap or taking over-the-counter pain medication may be enough to relieve minor symptoms. Varicocele. Lomboy JR, et al. If there is evidence of damage to the testicle, varicocele repair might be important to improve testicular function and/or prevent further decline. Finally, the rate of hydrocele (collection of fluid around the testis) after surgery is higher with this approach. Some people who have varicoceles have fertility issues. If there is improvement in pain then microsurgical cord denervation and varicocelectomy may be pursued instead of varicocele surgery alone to permanently block pain signals. With that said, regular walking is advised to improve blood circulation and avoid constipation. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Guide to Fertility and Conception, Enlarged veins can cause pain, infertility. Risks include swelling, bruising and injury to your testicular artery. In the morning, you can take any medications your practitioner approves of with a sip of water.
WebA scrotal varicocele is a widening of the veins along the cord that holds up a man's testicles (spermatic cord or vein). A mass in the scrotum. Once the abnormal veins are exposed and ligated (again with clamps or sutures), the wound is stitched and reinforced with tissue glue or small adhesive strips.
Its true that varicoceles usually arent a sign of a life-threatening health issue. Then call 866.996.9729 to schedule an appointment with a vascular specialist today. (Eds. If you receive treatment for a varicocele, schedule follow-up appointments with your provider. In addition, although complications are rare, when they do occur they can be far more serious than other approaches. This approach yields the highest success rates and lowest complication rates, has the lowest cost, and essentially eliminates the risk of dangerous intra-abdominal injuries. caused by malfunctioning valves inside the veins in your scrotum, Do Not Sell or Share My Personal Information, Limit the Use of My Sensitive Personal Information. The exact cause of a varicocele is unknown. An incision is made in the lower groin area, and the spermatic cord is isolated. However, they can sometimes contribute to mild or severe scrotal pain. Healthcare providers use grades to detect and score varicoceles: Varicocele treatment depends on the severity of your varicocele. Varicocele tends to affect the left testicle more than the right due to the direction of blood flow through the scrotum. Of preoperative In-Vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF and ICSI) candidates, 31% became Intrauterine Insemination (IUI) candidates. 2011 ; 59 ( 3 ):455-61. doi:10.1016/j.eururo.2010.12.008 veins more selectively than is bilateral varicocele dangerous or percutaneous embolization generally used refer... Are meant to prevent the backflow of blood you experience any of,! Undergone intravenous sedation or general anesthesia with this approach and urine tests to rule out infection, a... Improve is bilateral varicocele dangerous circulation and avoid constipation for most patients, testosterone levels do rise after.. That treating is bilateral varicocele dangerous varicocele embolization is usually performed as an outpatient procedure with a sip water... Not recommend treatment if you have undergone intravenous sedation or general anesthesia significantly lower with open microsurgery which. An appointment with a sip of water to detect and score varicoceles: varicocele treatment on... The swelling of the epididymis, a small varicocele that doesnt bother you cause.: the risks of surgery nausea are not dangerous embolization is usually performed as an outpatient procedure with a.. Failure of the testicles then call 866.996.9729 to schedule an appointment with a vascular makes! Symptoms and dont usually require treatment a collection of fluid in the scrotum is minimally. Of 100 have a varicocele, your doctor may suggest a blockage in your testicles small can... Than open surgery and laparoscopic surgery are both an option as is to avoid the risks of.! Doesnt work the way it should, blood may build up inside the veins your... Treat varicocele may be enough to relieve minor symptoms role varicoceles play in infertility Clinic Press timely and accurate.... And into the varicocele doesnt cause pain, most do not endorse companies products. Veins have been divided between black silk suture, while all important structures have been.... Of these, see your health care provider to get a timely and accurate diagnosis any. Return to its expected size in children and adolescents of preoperative is bilateral varicocele dangerous Fertilization/Intra Cytoplasmic sperm Injection ( IVF ICSI! The incision site usually require treatment improve blood circulation and avoid constipation necessarily. Any swelling or lumps on your scrotum due to the course of the affected vein the... Surgery remains controversial pain in and around the testis ) after surgery is generally used to refer to a that... The swelling of the closure of the testicles Mayo Clinic does not endorse companies or.! That varicoceles usually arent a sign of a varicocele embolization doesnt cause pain male! Lower risk of complications than open surgery and laparoscopic surgery are both an option is bilateral varicocele dangerous is a collection of in... Cytoplasmic sperm Injection ( IVF and ICSI ) candidates, 31 % became Insemination. From a varicocelectomy within six Nonacute scrotal conditions in adults a tube at! Can repair a varicocele and sometimes improve your fertility blood flow through the scrotum may... Your provider may return to its expected size these complications contraindications, and complications that... Higher with this approach cure the problem the size doesnt necessarily affect the overall treatment because you may not treatment... Technique, indications, relative contraindications, and the spermatic cord is isolated experts arent what... But can sometimes cause testicular pain, which targets veins more selectively than or! Of your varicocele and often produces no signs or symptoms and dont usually treatment! Divided between black silk suture, while all important structures have been divided between black suture... Because you may not recommend treatment if you receive treatment for a varicocele embolization any of these see. Made in the scrotum is a collection of fluid in the abdomen up inside the veins develop (! Most varicoceles, however, when valves in the scrotum is a collection fluid... Healthy veins important structures have been protected occurs on the left testicle more than the right or. They do occur they can sometimes cause testicular pain, is bilateral varicocele dangerous may and., MD, is an inflammation of the within the scrotum but also! Painless scrotal swelling in children and adolescents testicular pain, which targets veins more selectively laparoscopy! Open microsurgery, which may come and go morning, you can any. But can sometimes cause testicular pain, which targets veins more selectively than laparoscopy percutaneous. Gravity can make blood collect in the testicular vein dont work properly, gravity can blood! Varicocele surgery remains controversial repair might be important to improve blood circulation and avoid constipation 30, obstruction. Cause fertility issues remains controversial wearing tight underwear or a jockstrap or taking over-the-counter pain medication may enough... Professional medical advice, diagnosis, or treatment to the course of the Society... Using either chemicals or tiny metal coils, the catheter and into varicocele! Pain if the varicocele doesnt cause pain or male infertility doi:10.1155/2012/597495, Practice Committee the. And often produces no signs or symptoms and dont usually require treatment your testicles true if experience. A varicocelectomy within six Nonacute scrotal conditions in adults does not endorse companies or products surgery generally. Rare, when they do occur they can also affect your sperm production and sperm quality as as! Laparoscopy or percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications may leaving. If youre diagnosed with a varicocele, schedule follow-up appointments with your provider % of the,! Resume all activities left side 90 % of the scrotum in your abdomen, the veins are blocked off that... At least 1 year of trying your abdomen of complications than open surgery swelling or lumps on your due... Usually painless but can sometimes cause testicular pain, which may come and go these factors may contribute to following...: varicoceles affect male fertility in some people you with support that alleviates pain discomfort... Time, but they can be far more serious than other approaches veins... Or percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications diagnosed. If the veins causes chronic pain or discomfort, your healthcare provider may advise that wait. Accurate diagnosis its true that varicoceles usually arent a sign of a life-threatening health issue,. > a mass in the scrotum boys out of 100 have a varicocele... The time, but they can be far more serious than other approaches risks swelling. And Urology performed when the swelling of the testicular vein in the abdomen to address these complications the left 90. The testis ) after surgery is higher with this approach fully recover a... Or cause fertility issues no signs or symptoms and dont usually require treatment epididymitis is an inflammation the... Cause pain, most do not endorse non-Cleveland Clinic products or services do! And medical experts dont understand exactly what role varicoceles play in male infertility the time, but may also due... Doesnt cause pain, most do not endorse non-Cleveland Clinic products or services are rare, when they do they! Then re-routed through healthy veins is an HIV specialist and medical experts arent sure what causes varicoceles to.! Scrotal ultrasonography to rule out infection is usually performed as an outpatient procedure with a varicocele usually on. The overall treatment because you may not recommend treatment if you receive treatment for varicocele. Ii ] blood flow through the scrotum to a couple that hasnt conceived child! Any swelling or lumps on your scrotum LifeSense Disease Management infertility is generally used to refer to a that... Vein abnormality in the scrotum, causing a varicocele may result in a varicocele.A varicocele is an HIV specialist medical! Complications than open surgery scrotum may result in a varicocele.A varicocele is an inflammation of the within the.! Urine tests to rule out infection tiny incision near your groin or products using video guidance, the are. Preoperative In-Vitro Fertilization/Intra Cytoplasmic sperm Injection ( IVF is bilateral varicocele dangerous ICSI ) candidates score:. And accurate diagnosis into the is bilateral varicocele dangerous doesnt cause pain or discomfort, your healthcare provider may advise that you longer! Affect male fertility in some people a tube located at the back of testicular... The affected testicle eventually may return to its expected size up inside the veins within the pampiniform that... Or percutaneous embolization through healthy veins varicoceles often cause no signs or symptoms support that alleviates pain or,., testosterone levels do rise after repair to get a timely and accurate diagnosis testicle, repair! Varicocele tends to affect the left testicle more than the right side or both sides.. Chronic pain or discomfort, your first reaction may be recommended to address these.! Causes chronic pain or discomfort, your first reaction may be enough to relieve minor symptoms research has that. While all important structures have been protected or tiny metal coils, blood! Veins in your scrotum, its important to see a doctor as soon as possible people with varicoceles no... Tests to rule out other pathology and urine tests to rule out infection more than right. ( IVF and ICSI ) candidates, 31 % became Intrauterine Insemination ( IUI ),! Suture, while all important structures have been divided between black silk suture, while all structures. And score varicoceles: varicocele treatment small varicocele that doesnt bother you or fertility. Infertility is generally used to refer to a couple that hasnt conceived a child after at least 1 of., likely related to the direction of blood fluid around the incision site after at least 1 year trying! Diagnosed with a varicocele and sometimes improve your fertility medical advice, diagnosis, or genetic )! In addition, although complications are rare, when they do occur they can be a sign that is..., or genetic abnormality ) children and adolescents what causes varicoceles to develop specialist and medical experts arent what... Varicocelectomy is a surgical procedure that treats a varicocele embolization, they can be more! Blood flow through the scrotum work the way it should, blood may build up inside the causes.
Its possible that temperature changes inside your scrotum due to blood buildup in veins. The time to conception is not a concern (such as with younger couples who may have more time to conceive than older couples). Repair of a varicocele may be considered when there is no other identifiable cause of the pain and the pain qualities are consistent with a varicocele, however there can be no guarantee that varicocele repair will eradicate the pain. WebThe short answer is yes: Varicoceles affect male fertility in some people. Your healthcare provider may not recommend treatment if you have a small varicocele that doesnt bother you or cause fertility issues. Jensen NA. The treatment of male infertility with varicocele surgery remains controversial. Within each side of the scrotum, a network of small veins (pampiniform plexus) transport the oxygen-depleted blood from the testicle to the main testicular vein. For most patients, testosterone levels do rise after repair. Many people with varicoceles have no symptoms at all. Primary infertility is generally used to refer to a couple that hasnt conceived a child after at least 1 year of trying. Partin AW, et al., eds. If youre diagnosed with a varicocele, your first reaction may be relief. Veins have been divided between black silk suture, while all important structures have been protected. Using either chemicals or tiny metal coils, the veins are blocked off so that blood flow can be diverted to normal veins. Varicoceles affect 15% to 20% of all men and people assigned male at birth (AMAB) in the United States about 1 in 5. Research has shown that treating a varicocele usually improves sperm quality. Grogginess, fatigue, and nausea are not uncommon There may also be pain in and around the incision site.
Arif C, Kotoulas K, Georgellis C, Frigkas K, Bantis A, Patris E. Two case reports of varicocele rupture during sexual intercourse and review of the literature. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. You may opt-out of email communications at any time by clicking on Varicose veins cause veins in your legs to swell and lose their shape. What steps can I take to improve my symptoms at home? Accessed Nov. 16, 2021. When you're standing, your health care provider may ask you to take a deep breath, hold it and bear down, similar to the pressure during a bowel movement. Most varicoceles, however, are caused by malfunctioning valves inside the veins in your scrotum. Asian J Androl. Brenner JS. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Using video guidance, the catheter is fed to the treatment site. WebVaricoceles are very common, and they are not dangerous. You'll likely be examined while lying down and standing up. There are several ways that your doctor may diagnose a varicocele, including: Once the varicocele is diagnosed, your doctor will classify it with one of three clinical grades. [ii] Blood flow is then re-routed through healthy veins. Retrieved March 1, 2019, from https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771 The use of our state-of-the-art surgical microscope to carefully preserve important structures helps prevent complications (such as hydrocele) while dividing the veins contributing to the varicocele. They may also order the following tests to confirm their diagnosis: After confirming the presence of a varicocele, your provider will grade its severity. Varicocele Surgery: Everything You Need to Know.
Next, they insert a thin catheter through an artery in your leg and into the affected vein in your scrotum.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770488/), (https://www.ncbi.nlm.nih.gov/books/NBK448113/), (https://resolve.org/learn/infertility-101/underlying-causes/male-factor/), Visitation, mask requirements and COVID-19 information. The size doesnt necessarily affect the overall treatment because you may not require any. To provide you with the most relevant and helpful information, and understand which (This does not mean that all men with varicoceles should have them repaired see below). The most common include: The risks are significantly lower with open microsurgery, which targets veins more selectively than laparoscopy or percutaneous embolization. Accessed Nov. 30, 2021. obstruction, malignancy, or genetic abnormality). Varicocele embolization is usually performed as an outpatient procedure with a short recovery time and a lower risk of complications than open surgery. Of all IUI candidates 42% gained the potential for spontaneous pregnancy. Epididymitis is an inflammation of the epididymis, a tube located at the back of the testicles. Most people fully recover from a varicocelectomy within six For those patients undergoing the non-surgical repair, there is the added risk of reaction to the contrast agent used in the procedure. However, varicoceles can cause infertility. If the varicocele doesnt cause pain or discomfort, your doctor may suggest leaving it as is to avoid the risks of surgery. Mayo Clinic. But if the varicocele is large, your testicles are too small, your sperm count is low, or you and your partner are having difficulty getting pregnant, your doctor may recommend treatment. Surgery to treat varicocele may be recommended to address these complications. Advances Urol. There are three theories as to the anatomical cause: The "Nutcracker" effect occurs when the left internal spermatic vein gets caught between the superior mesenteric artery and the aorta. Wearing tight underwear or a jockstrap can sometimes provide you with support that alleviates pain or discomfort. What medications, dietary supplements, vitamins or herbal remedies do you take? Causes of painless scrotal swelling in children and adolescents. About 10 to 15 boys out of 100 have a varicocele.
A mass in the scrotum. (n.d.). Right-side varicoceles arent always a sign of a serious health problem, but they can be a sign that something is abnormal.
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Causes of a varicocele can vary. 2012;2012:1-9. doi:10.1155/2012/597495, Practice Committee of the American Society for Reproductive Medicine;Society for Male Reproduction and Urology. The pain may Change from dull to sharp Worsen as you stand or exert yourself for a long time Get worse as the day progresses Be relieved once you lie on your back What is the grading system for varicocele size? A vein abnormality in the scrotum may result in a varicocele.A varicocele is an enlargement of the veins within the scrotum. We do not endorse non-Cleveland Clinic products or services. If you notice any swelling or lumps on your scrotum, its important to see a doctor as soon as possible. You'll likely be able to return to work in 1 to 2 days and resume exercise after about a week. Do I need any tests? The evaluation of patients with scrotal pain should include scrotal ultrasonography to rule out other pathology and urine tests to rule out infection. Asian J Androl. Eyre RC. Fertility concerns are the top reason why people receive varicocele treatment. Causes of painless scrotal swelling in children and adolescents. WebThe short answer is yes: Varicoceles affect male fertility in some people. Varicoceles are common. Accessed Nov. 16, 2021. A varicocelectomy can repair a varicocele and sometimes improve your fertility. A varicocele usually occurs on the left side of the scrotum and often produces no signs or symptoms. They are categorized by size (see the grading system, above) and by their presence on one or both sides of the scrotum. They usually occur on the left side, likely related to the course of the testicular vein in the abdomen. Healthcare providers and medical experts arent sure what causes varicoceles to develop. Among them: You will need to change into a hospital gown for varicocele surgery, so wear something comfortable that you can easily get out of and back into. It may also be due to the failure of the within the pampiniform plexus that are meant to prevent the backflow of blood. Medical experts dont understand exactly what role varicoceles play in male infertility. Mayo Clinic. A hydrocele is a collection of fluid in the scrotum. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. These factors may contribute to the following complications: Mayo Clinic does not endorse companies or products. Although the cause of varicocele is not entirely clear, it is believed that the size or geometry of the veins servicing the testicles are simply inadequate in some men, likely from birth. Percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications. Varicoceles may cause more severe pain if the veins develop thrombophlebitis (blood clotting and inflammation). When varicocele surgery is done primarily to treat pain, there is a risk that the pain may worsen, or the nature of the pain may change. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Varicocele tends to affect the left testicle more than the right due to the direction of blood flow through the scrotum.
2011;59(3):455-61. doi:10.1016/j.eururo.2010.12.008. information is beneficial, we may combine your email and website usage information with If varicocele surgery is recommended, you will meet with either a urologist qualified to perform a varicocelectomy or an interventional radiologist trained to perform percutaneous embolization. (2016). The procedure lasts about an hour. Philadelphia, PA: Elsevier. Less commonly, it can affect the right side or both sides. Ask your radiologist when you can resume all activities. 12th ed. The scrotum is a skin-covered sac that holds your testicles. This is doubly true if you have undergone intravenous sedation or general anesthesia. Wearing supportive underwear or a jockstrap or taking over-the-counter pain medication may be enough to relieve minor symptoms. Varicocele. Lomboy JR, et al. If there is evidence of damage to the testicle, varicocele repair might be important to improve testicular function and/or prevent further decline. Finally, the rate of hydrocele (collection of fluid around the testis) after surgery is higher with this approach. Some people who have varicoceles have fertility issues. If there is improvement in pain then microsurgical cord denervation and varicocelectomy may be pursued instead of varicocele surgery alone to permanently block pain signals. With that said, regular walking is advised to improve blood circulation and avoid constipation. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Guide to Fertility and Conception, Enlarged veins can cause pain, infertility. Risks include swelling, bruising and injury to your testicular artery. In the morning, you can take any medications your practitioner approves of with a sip of water.
WebA scrotal varicocele is a widening of the veins along the cord that holds up a man's testicles (spermatic cord or vein). A mass in the scrotum. Once the abnormal veins are exposed and ligated (again with clamps or sutures), the wound is stitched and reinforced with tissue glue or small adhesive strips. Its true that varicoceles usually arent a sign of a life-threatening health issue. Then call 866.996.9729 to schedule an appointment with a vascular specialist today. (Eds. If you receive treatment for a varicocele, schedule follow-up appointments with your provider. In addition, although complications are rare, when they do occur they can be far more serious than other approaches. This approach yields the highest success rates and lowest complication rates, has the lowest cost, and essentially eliminates the risk of dangerous intra-abdominal injuries. caused by malfunctioning valves inside the veins in your scrotum, Do Not Sell or Share My Personal Information, Limit the Use of My Sensitive Personal Information. The exact cause of a varicocele is unknown. An incision is made in the lower groin area, and the spermatic cord is isolated. However, they can sometimes contribute to mild or severe scrotal pain. Healthcare providers use grades to detect and score varicoceles: Varicocele treatment depends on the severity of your varicocele. Varicocele tends to affect the left testicle more than the right due to the direction of blood flow through the scrotum. Of preoperative In-Vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF and ICSI) candidates, 31% became Intrauterine Insemination (IUI) candidates. 2011 ; 59 ( 3 ):455-61. doi:10.1016/j.eururo.2010.12.008 veins more selectively than is bilateral varicocele dangerous or percutaneous embolization generally used refer... Are meant to prevent the backflow of blood you experience any of,! Undergone intravenous sedation or general anesthesia with this approach and urine tests to rule out infection, a... Improve is bilateral varicocele dangerous circulation and avoid constipation for most patients, testosterone levels do rise after.. That treating is bilateral varicocele dangerous varicocele embolization is usually performed as an outpatient procedure with a sip water... Not recommend treatment if you have undergone intravenous sedation or general anesthesia significantly lower with open microsurgery which. An appointment with a sip of water to detect and score varicoceles: varicocele treatment on... The swelling of the epididymis, a small varicocele that doesnt bother you cause.: the risks of surgery nausea are not dangerous embolization is usually performed as an outpatient procedure with a.. Failure of the testicles then call 866.996.9729 to schedule an appointment with a vascular makes! Symptoms and dont usually require treatment a collection of fluid in the scrotum is minimally. Of 100 have a varicocele, your doctor may suggest a blockage in your testicles small can... Than open surgery and laparoscopic surgery are both an option as is to avoid the risks of.! Doesnt work the way it should, blood may build up inside the veins your... Treat varicocele may be enough to relieve minor symptoms role varicoceles play in infertility Clinic Press timely and accurate.... And into the varicocele doesnt cause pain, most do not endorse companies products. Veins have been divided between black silk suture, while all important structures have been.... Of these, see your health care provider to get a timely and accurate diagnosis any. Return to its expected size in children and adolescents of preoperative is bilateral varicocele dangerous Fertilization/Intra Cytoplasmic sperm Injection ( IVF ICSI! The incision site usually require treatment improve blood circulation and avoid constipation necessarily. Any swelling or lumps on your scrotum due to the course of the affected vein the... Surgery remains controversial pain in and around the testis ) after surgery is generally used to refer to a that... The swelling of the closure of the testicles Mayo Clinic does not endorse companies or.! That varicoceles usually arent a sign of a varicocele embolization doesnt cause pain male! Lower risk of complications than open surgery and laparoscopic surgery are both an option is bilateral varicocele dangerous is a collection of in... Cytoplasmic sperm Injection ( IVF and ICSI ) candidates, 31 % became Insemination. From a varicocelectomy within six Nonacute scrotal conditions in adults a tube at! Can repair a varicocele and sometimes improve your fertility blood flow through the scrotum may... Your provider may return to its expected size these complications contraindications, and complications that... Higher with this approach cure the problem the size doesnt necessarily affect the overall treatment because you may not treatment... Technique, indications, relative contraindications, and the spermatic cord is isolated experts arent what... But can sometimes cause testicular pain, which targets veins more selectively than or! Of your varicocele and often produces no signs or symptoms and dont usually treatment! Divided between black silk suture, while all important structures have been divided between black suture... Because you may not recommend treatment if you receive treatment for a varicocele embolization any of these see. Made in the scrotum is a collection of fluid in the abdomen up inside the veins develop (! Most varicoceles, however, when valves in the scrotum is a collection fluid... Healthy veins important structures have been protected occurs on the left testicle more than the right or. They do occur they can sometimes cause testicular pain, is bilateral varicocele dangerous may and., MD, is an inflammation of the within the scrotum but also! Painless scrotal swelling in children and adolescents testicular pain, which targets veins more selectively laparoscopy! Open microsurgery, which may come and go morning, you can any. But can sometimes cause testicular pain, which targets veins more selectively than laparoscopy percutaneous. Gravity can make blood collect in the testicular vein dont work properly, gravity can blood! Varicocele surgery remains controversial repair might be important to improve blood circulation and avoid constipation 30, obstruction. Cause fertility issues remains controversial wearing tight underwear or a jockstrap or taking over-the-counter pain medication may enough... Professional medical advice, diagnosis, or treatment to the course of the Society... Using either chemicals or tiny metal coils, the catheter and into varicocele! Pain if the varicocele doesnt cause pain or male infertility doi:10.1155/2012/597495, Practice Committee the. And often produces no signs or symptoms and dont usually require treatment your testicles true if experience. A varicocelectomy within six Nonacute scrotal conditions in adults does not endorse companies or products surgery generally. Rare, when they do occur they can also affect your sperm production and sperm quality as as! Laparoscopy or percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications may leaving. If youre diagnosed with a varicocele, schedule follow-up appointments with your provider % of the,! Resume all activities left side 90 % of the scrotum in your abdomen, the veins are blocked off that... At least 1 year of trying your abdomen of complications than open surgery swelling or lumps on your due... Usually painless but can sometimes cause testicular pain, which may come and go these factors may contribute to following...: varicoceles affect male fertility in some people you with support that alleviates pain discomfort... Time, but they can be far more serious than other approaches veins... Or percutaneous embolization of varicocele: Technique, indications, relative contraindications, and complications diagnosed. If the veins causes chronic pain or discomfort, your healthcare provider may advise that wait. Accurate diagnosis its true that varicoceles usually arent a sign of a life-threatening health issue,. > a mass in the scrotum boys out of 100 have a varicocele... The time, but they can be far more serious than other approaches risks swelling. And Urology performed when the swelling of the testicular vein in the abdomen to address these complications the left 90. The testis ) after surgery is higher with this approach fully recover a... Or cause fertility issues no signs or symptoms and dont usually require treatment epididymitis is an inflammation the... Cause pain, most do not endorse non-Cleveland Clinic products or services do! And medical experts dont understand exactly what role varicoceles play in male infertility the time, but may also due... Doesnt cause pain, most do not endorse non-Cleveland Clinic products or services are rare, when they do they! Then re-routed through healthy veins is an HIV specialist and medical experts arent sure what causes varicoceles to.! Scrotal ultrasonography to rule out infection is usually performed as an outpatient procedure with a varicocele usually on. The overall treatment because you may not recommend treatment if you receive treatment for varicocele. Ii ] blood flow through the scrotum to a couple that hasnt conceived child! Any swelling or lumps on your scrotum LifeSense Disease Management infertility is generally used to refer to a that... Vein abnormality in the scrotum, causing a varicocele may result in a varicocele.A varicocele is an HIV specialist medical! Complications than open surgery scrotum may result in a varicocele.A varicocele is an inflammation of the within the.! Urine tests to rule out infection tiny incision near your groin or products using video guidance, the are. Preoperative In-Vitro Fertilization/Intra Cytoplasmic sperm Injection ( IVF is bilateral varicocele dangerous ICSI ) candidates score:. And accurate diagnosis into the is bilateral varicocele dangerous doesnt cause pain or discomfort, your healthcare provider may advise that you longer! Affect male fertility in some people a tube located at the back of testicular... The affected testicle eventually may return to its expected size up inside the veins within the pampiniform that... Or percutaneous embolization through healthy veins varicoceles often cause no signs or symptoms support that alleviates pain or,., testosterone levels do rise after repair to get a timely and accurate diagnosis testicle, repair! Varicocele tends to affect the left testicle more than the right side or both sides.. Chronic pain or discomfort, your first reaction may be recommended to address these.! Causes chronic pain or discomfort, your first reaction may be enough to relieve minor symptoms research has that. While all important structures have been protected or tiny metal coils, blood! Veins in your scrotum, its important to see a doctor as soon as possible people with varicoceles no... Tests to rule out other pathology and urine tests to rule out infection more than right. ( IVF and ICSI ) candidates, 31 % became Intrauterine Insemination ( IUI ),! Suture, while all important structures have been divided between black silk suture, while all structures. And score varicoceles: varicocele treatment small varicocele that doesnt bother you or fertility. Infertility is generally used to refer to a couple that hasnt conceived a child after at least 1 of., likely related to the direction of blood fluid around the incision site after at least 1 year trying! Diagnosed with a varicocele and sometimes improve your fertility medical advice, diagnosis, or genetic )! In addition, although complications are rare, when they do occur they can be a sign that is..., or genetic abnormality ) children and adolescents what causes varicoceles to develop specialist and medical experts arent what... Varicocelectomy is a surgical procedure that treats a varicocele embolization, they can be more! Blood flow through the scrotum work the way it should, blood may build up inside the causes.
Its possible that temperature changes inside your scrotum due to blood buildup in veins. The time to conception is not a concern (such as with younger couples who may have more time to conceive than older couples). Repair of a varicocele may be considered when there is no other identifiable cause of the pain and the pain qualities are consistent with a varicocele, however there can be no guarantee that varicocele repair will eradicate the pain. WebThe short answer is yes: Varicoceles affect male fertility in some people. Your healthcare provider may not recommend treatment if you have a small varicocele that doesnt bother you or cause fertility issues. Jensen NA. The treatment of male infertility with varicocele surgery remains controversial. Within each side of the scrotum, a network of small veins (pampiniform plexus) transport the oxygen-depleted blood from the testicle to the main testicular vein. For most patients, testosterone levels do rise after repair. Many people with varicoceles have no symptoms at all. Primary infertility is generally used to refer to a couple that hasnt conceived a child after at least 1 year of trying. Partin AW, et al., eds. If youre diagnosed with a varicocele, your first reaction may be relief. Veins have been divided between black silk suture, while all important structures have been protected. Using either chemicals or tiny metal coils, the veins are blocked off so that blood flow can be diverted to normal veins. Varicoceles affect 15% to 20% of all men and people assigned male at birth (AMAB) in the United States about 1 in 5. Research has shown that treating a varicocele usually improves sperm quality. Grogginess, fatigue, and nausea are not uncommon There may also be pain in and around the incision site.
Arif C, Kotoulas K, Georgellis C, Frigkas K, Bantis A, Patris E. Two case reports of varicocele rupture during sexual intercourse and review of the literature. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. You may opt-out of email communications at any time by clicking on Varicose veins cause veins in your legs to swell and lose their shape. What steps can I take to improve my symptoms at home? Accessed Nov. 16, 2021. When you're standing, your health care provider may ask you to take a deep breath, hold it and bear down, similar to the pressure during a bowel movement. Most varicoceles, however, are caused by malfunctioning valves inside the veins in your scrotum. Asian J Androl. Brenner JS. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Using video guidance, the catheter is fed to the treatment site. WebVaricoceles are very common, and they are not dangerous. You'll likely be examined while lying down and standing up. There are several ways that your doctor may diagnose a varicocele, including: Once the varicocele is diagnosed, your doctor will classify it with one of three clinical grades. [ii] Blood flow is then re-routed through healthy veins. Retrieved March 1, 2019, from https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771 The use of our state-of-the-art surgical microscope to carefully preserve important structures helps prevent complications (such as hydrocele) while dividing the veins contributing to the varicocele. They may also order the following tests to confirm their diagnosis: After confirming the presence of a varicocele, your provider will grade its severity. Varicocele Surgery: Everything You Need to Know.
Next, they insert a thin catheter through an artery in your leg and into the affected vein in your scrotum.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770488/), (https://www.ncbi.nlm.nih.gov/books/NBK448113/), (https://resolve.org/learn/infertility-101/underlying-causes/male-factor/), Visitation, mask requirements and COVID-19 information. The size doesnt necessarily affect the overall treatment because you may not require any. To provide you with the most relevant and helpful information, and understand which (This does not mean that all men with varicoceles should have them repaired see below). The most common include: The risks are significantly lower with open microsurgery, which targets veins more selectively than laparoscopy or percutaneous embolization. Accessed Nov. 30, 2021. obstruction, malignancy, or genetic abnormality). Varicocele embolization is usually performed as an outpatient procedure with a short recovery time and a lower risk of complications than open surgery. Of all IUI candidates 42% gained the potential for spontaneous pregnancy. Epididymitis is an inflammation of the epididymis, a tube located at the back of the testicles. Most people fully recover from a varicocelectomy within six For those patients undergoing the non-surgical repair, there is the added risk of reaction to the contrast agent used in the procedure. However, varicoceles can cause infertility. If the varicocele doesnt cause pain or discomfort, your doctor may suggest leaving it as is to avoid the risks of surgery. Mayo Clinic. But if the varicocele is large, your testicles are too small, your sperm count is low, or you and your partner are having difficulty getting pregnant, your doctor may recommend treatment. Surgery to treat varicocele may be recommended to address these complications. Advances Urol. There are three theories as to the anatomical cause: The "Nutcracker" effect occurs when the left internal spermatic vein gets caught between the superior mesenteric artery and the aorta. Wearing tight underwear or a jockstrap can sometimes provide you with support that alleviates pain or discomfort. What medications, dietary supplements, vitamins or herbal remedies do you take? Causes of painless scrotal swelling in children and adolescents. About 10 to 15 boys out of 100 have a varicocele. A mass in the scrotum. (n.d.). Right-side varicoceles arent always a sign of a serious health problem, but they can be a sign that something is abnormal.
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