An enlarged vein in the scrotum is called a varicocele. These enlarged veins are also called scrotum varicose veins and are extremely common. Varicoceles are not dangerous and typically cause no symptoms – although it can lower sperm production in the testicles and reduce sperm quality, leading to male infertility.
How Do Varicose Veins Develop in the Scrotum?
Veins in the scrotum may become enlarged in the same way a person might develop varicose veins in the legs or elsewhere, typically as the result of venous reflux.
Reflux in this context refers to the backward flow of blood. This occurs due to weak or faulty valves within veins that are supposed to help blood flow upward, toward the heart. When these valves fail to properly close, blood backs up and collects in the veins of the scrotum, causing those veins to become engorged and more visibly noticeable – i.e., varicose.
What to Look For
Varicoceles most often develop at or just after puberty.
Once a varicocele develops, it tends to become more noticeable over time. These stretched and swollen veins can look and feel like worms under the skin – and may appear either above the testicle or on the side of the scrotum.
Notably, varicoceles tend to occur on the left side of the scrotum (the area around the left testicle) instead of the right, because blood flow in men is greater on the left side. Even so, varicoceles sometimes appear on both sides. In rare cases, when varicoceles appear on both sides, or a varicocele develops suddenly in men 40 years old or older, it may indicate a more serious vascular blockage elsewhere in the body, such as an abdominal aortic aneurysm.
Varicoceles typically cause no symptoms, although if the veins become swollen enough, it may cause the following signs or symptoms in the area of the scrotum:
- Discomfort, aches, or pain, especially when sitting or standing for long periods of time
- Sensation of heaviness
- Throbbing or tingling
- Dilated veins that can be seen and felt
- Testicles are different sizes
Complications of Varicocele
Varicose veins in the scrotum can cause the following treatable complications:
- Testicular atrophy (shrinking of the affected testicle). The engorged tangle of varicose veins increases pressure in the vessels supplying the testicle with blood, causing the testicle to shrink. Treatment of the varicocele often restores an affected testicle to its original size.
- Male infertility. It is believed that the enlarged veins in the scrotum increase testicle temperature, which harms sperm production. The presence of a varicocele is associated with lowered sperm production and decreased quality and motility in the sperm that is produced.
Diagnosis & Treatment
Varicoceles can be diagnosed with a physical exam. A semen test may be recommended if infertility is a concern, and a duplex ultrasound may be used to measure blood flow and identify which veins are not working properly. If enlarged veins are present on both sides of the scrotum, additional diagnostic imaging tests may be recommended to rule out vascular problems elsewhere in the body, such as an abdominal aortic aneurysm.
For mild cases, your doctor may recommend anti-inflammatories and supportive undergarments, such as snug briefs or a jock strap to help alleviate any pain and swelling associated with a varicocele.
If the varicocele is causing harm to the testicles or sperm production, a minimally invasive procedure called varicocele embolization can be just as effective as traditional surgery to remove the vein (a procedure called a surgical ligation) – while allowing the patient to avoid the risks, post-op pain, and recovery time associated with surgery.
Varicocele embolization involves threading a tiny catheter from a vein at the groin to the target area in the scrotum. Once positioned correctly, using imaging guidance, an interventional radiologist will deliver materials to block blood flow to the varicose veins, causing the veins to shrink. Blood flow in the area is redirected through other, healthier veins, essentially bypassing the problematic veins.
Varicocele Treatment in Miami Lakes, Plantation, Coconut Creek, and Aventura, FL
Do you have a varicocele? Is it impacting testicle size? Are you having fertility concerns?
The interventional radiologists at Florida Endovascular and Interventional in South Florida can help. Call us at (786) 534-2555 to discuss your varicocele treatment options – or whether treatment is necessary. You can also use our convenient online appointment request form if you prefer.