Varicocele: Symptoms and When to Seek Treatment

Varicocele

Hello, Doctor Xu.
I am 30 years old.
I discovered that I had a left-sided varicocele in the fourth grade of elementary school.
I have previously been examined at a large hospital, and since there was no swelling or pain, surgery was not necessary.
Recently, I have been feeling occasional movement in the left varicocele, such as when I stand up or sit down; it happens occasionally.
There are no signs of the varicocele increasing in size.
Could this indicate any abnormalities? Thank you!

DD, 30~39 year old female. Ask Date: 2014/08/12

Dr. Xu Wencang reply Urology

Most patients with varicocele experience a sensation of "heaviness" or "fullness," and the feeling during movement may be associated with the contraction of the cremaster muscle.

Reply Date: 2014/08/12

More Info

Varicocele is a condition characterized by the enlargement of the veins within the scrotum, specifically the pampiniform plexus, which is a network of veins that drain blood from the testicles. It is often compared to varicose veins that occur in the legs. While varicocele is relatively common, particularly on the left side, it can lead to various symptoms and complications if left untreated.

Symptoms of Varicocele
Many individuals with varicocele may not experience noticeable symptoms. However, some common symptoms can include:
1. Dull Pain or Discomfort: This is often described as a feeling of heaviness in the scrotum, particularly after prolonged standing or physical activity.

2. Visible or Palpable Veins: The affected veins may become enlarged and can be felt as a "bag of worms" when standing.

3. Changes in Testicular Size: There may be a noticeable difference in size between the affected and unaffected testicle, often with the affected testicle being smaller.

4. Fertility Issues: Varicocele is associated with male infertility due to its potential impact on sperm production and quality.

5. Testicular Atrophy: In some cases, the affected testicle may shrink over time.

When to Seek Treatment
You mentioned that you have been diagnosed with left-sided varicocele since elementary school and that it has not caused significant pain or discomfort. However, there are certain situations where seeking treatment would be advisable:
1. Persistent Pain or Discomfort: If you start to experience chronic pain or discomfort that affects your daily activities, it may be time to consult a healthcare provider.

2. Changes in Testicular Size: If you notice a significant change in the size of your testicles, particularly if one becomes smaller, this warrants further evaluation.

3. Fertility Concerns: If you are planning to start a family and have concerns about fertility, it is essential to discuss this with a urologist, as varicocele can impact sperm quality.

4. Visible Changes: If the varicocele appears to be enlarging or if you notice any unusual changes in the scrotum, it is important to seek medical advice.

Diagnosis and Treatment Options
Diagnosis typically involves a physical examination and may include an ultrasound to assess the veins and blood flow. If treatment is necessary, options may include:
1. Surgical Intervention: Varicocelectomy is a surgical procedure to remove the affected veins. This is often recommended for symptomatic cases or when fertility is a concern.

2. Embolization: This is a minimally invasive procedure where a catheter is used to block the affected veins, redirecting blood flow to healthier veins.

Conclusion
In your case, since you have not experienced significant symptoms or changes in the size of the varicocele, it may not require immediate treatment. However, it is essential to monitor any changes in symptoms or discomfort. If you have concerns about fertility or experience new symptoms, consulting a urologist would be a prudent step. Regular follow-ups can help ensure that any potential complications are addressed early on. Always prioritize open communication with your healthcare provider regarding any changes or concerns you may have about your condition.

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