Varicocele

February 2017


Definition


Varicocele is a dilation of the veins in the spermatic cord, itself located in the scrotum. In nine cases out of ten, it occurs on the left side, due to a malfunction of a valve located in the left renal vein that drains the spermatic vein. This valve insufficiency leads to an accumulation of blood in the spermatic vein, hence its expansion. It is a benign condition that affects approximately 10% of men. Varicocele can cause fertility problems.

Symptoms


Symptoms of varicocele are:
  • an increase in the volume of the testicle;
  • a feeling of heaviness in the testicle;
  • more pain later in the day or during exercise;
  • cosmetic discomfort.

Diagnosis


Varicocele is detected by physical examination where a small soft mass is found, located in the posterior and upper testicle. The swelling tends to be more visible when standing over a patient in the prone position, and when a Valsalva test is performed: the patient pinches his nose, closes his mouth and blows. A Doppler ultrasound will be performed to highlight the slowdown and stagnation of blood and the dilation of the vein flow. More rarely, venography to visualize the veins after an injection of a radiopaque substance, or an X-ray are prescribed.

Treatment


Varicocele is treated by surgery, by performing a vein ligation to remove the expansion. It is also possible to use the technique of embolization during venography, which allows the blockage of the vein involved. Painkillers are prescribed in all cases.

Related

Original article published by . Translated by Jeff. Latest update on July 23, 2013 at 12:40 PM by Jeff.
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