Varicocele

Important information:

Varicose veins are swollen veins that develop in the legs. These veins can also develop in the scrotum. This is called a varicocele. 

What is a varicocele? 

There are veins in the scrotum that drain blood from the testicles up towards the heart. Blood that is slow to return to the heart can collect in these veins. This can cause the veins to get bigger or become swollen. When this happens in the scrotum, it is called a varicocele.

Who can develop a varicocele?

Varicoceles are common. About 17% of males between the ages of 13-25 years old develop them. More than 90% of the time, varicoceles appear on the left side of the scrotum and usually occurs during or after puberty when the testicles rapidly grow.

What are the symptoms of a varicocele?

There may be no symptoms. A boy might not know that he has a varicocele. Usually, a varicocele is discovered during a testicular exam at a routine check-up. During testicular exam, the veins will feel like a “bag of worms” while standing and then the veins may disappear while lying down. After heavy exercise, in hot weather, or standing for a long period of time, they may feel a heaviness or dull discomfort in the scrotum.

What is the treatment of a varicocele?

During a testicular exam, the healthcare provider will:

• Assess for the presence of a varicocele 

• Check the testicular size

• Determine the current stage of puberty

A varicocele is usually harmless. It usually does not affect the ability to father a child. There is a small chance that it could affect sperm production. When a young man has completed puberty, his healthcare provider will recommend a semen analysis and hormonal blood labs. This is done to measure the amount of sperm made by the testes and check if hormonal levels are normal.

Wearing a supportive device, such as a jock strap or compression athletic undershorts, during sport activities will help decrease any swelling or discomfort.

Varicocele does not usually require surgical intervention. Surgery may be considered if:

• The semen analysis shows a consistent sperm count of less than 20 million/ml.

• Low sperm motility affecting the total motile sperm count.

• Abnormal androgen hormone levels.

Contact your CHOP healthcare team with questions or concerns. 

Reviewed February 2024 by Tara Phillips, CRNP