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Typical varicocele symptoms are mild and many do not require treatment.
Treatment may be necessary if the varicocele is causing discomfort
or any of the other problems listed below.
Signs of Varicoceles
Pain
One of the signs of varicoceles is 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 varicocele symptoms
worse and, in some cases, can even cause varicoceles to form. Usually
(but not always) painful varicoceles are prominent in size.
Fertility Problems
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.
Other signs of varicoceles can be 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 percent 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.
Testicular Atrophy
Atrophy, or shrinking, of the testicles is another of the signs
of 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.
Diagnosis
 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" (see Figure 2).
When varicocele symptoms are not clearly present, 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 |
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