Symptoms and causes

What is it?

A varicocoele is a varicose vein of the blood vessels of the testicle. It is a benign condition that affects about 15% of young adults. The disorder occurs at the beginning of puberty, almost always on the left side.

Later in life, 20% of adult men with a varicocoele show fertility problems. The sperm quality may improve after a varicose vein treatment.

Most varicocoeles are not accompanied by symptoms and are therefore often discovered accidentally during a physical examination.

Diagnosis and treatment

How is the diagnosis determined?

  • Physical examination: the doctor (or the patient) identifies a tangle of blood vessels located above the testicle (it feels like worms) and can assess the severity of the condition (grades 1 to 3).
  • Ultrasound imaging with Doppler: the doctor measures the return of blood in the varicose vein. She or he also measures the size of the testicle to see if there is any damage to the affected testicle.

Treatment

A varicocoele does not always require treatment. The decision to proceed with treatment depends on many factors such as the severity of the varicocoele, possible damage to the testicle, age at diagnosis and the presence of fertility problems. If it is decided to actively treat a varicocoele, there are various methods of treatment:

  1. Embolisation of the veins: through a kidney vein, the testicular artery is searched for and embolised (sprayed shut).
  2. Laparoscopic binding of the veins. This is done by laparoscopy or keyhole surgery in the abdomen.
  3. The inguinal canal is used to tie off the testicular vein. To do so, a skin incision must be made in the groin area.

Treatment centres and specialisations

Urology Centre

Latest publication date: 25/01/2021
Supervising author: Dr Ameye Filip