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What are Varicoceles?

Varicoceles are enlarged veins in the scrotum caused by defective valves inside the veins that drain blood from the testicles. This causes blood to pool in the veins, leading to swelling and enlargement. Varicoceles are a common condition, affecting around 15% of men. They often develop during puberty but can occur later in life.

The main symptoms of varicoceles include: discomfort or pain in the scrotum, visible or feelable enlarged veins in the scrotum, reduced fertility, and shrinking or wasting away of the testicle on the affected side. Varicoceles usually occur on the left side, due to differences in how the left and right testicular veins drain. The swelling and pooling of blood in the veins can increase testicular temperature, impacting sperm production.

Diagnosing Varicoceles

Varicoceles are typically diagnosed through a physical exam by a urologist. The doctor will feel for enlarged veins in the scrotum. Varicoceles are often more visible or pronounced when standing, so the exam may be done in both lying down and standing positions.

Your doctor may order imaging tests, like a scrotal ultrasound, to get a closer look at the enlarged veins. They may also grade the varicocele based on the size of the veins and their visibility during a Valsalva maneuver, which involves bearing down or holding your breath to increase chest pressure.

Treating Varicoceles

If varicocele symptoms are minor and fertility is unaffected, your doctor may recommend just observing the condition and making lifestyle changes. For symptomatic varicoceles, treatment options include:

Over-the-counter pain relievers can provide relief from varicocele discomfort.

Tying off or removing the enlarged veins through open or laparoscopic surgery. This is effective at reducing swelling and pain.

A less invasive surgical option that uses magnification to preserve arteries around veins that are tied off.

Blocking the enlarged veins using a catheter inserted through the groin or neck.

These treatments can improve fertility in about 70% of affected men. Follow up exams and semen analysis can confirm treatment effectiveness.

Caring for Yourself Post-Treatment

To support recovery after varicocele treatment:

With the right diagnosis and treatment from an experienced urologist, most men can find relief from varicocele discomfort and improvement in their fertility.

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