A varicocele is an enlargement of the veins that drain blood from the testicle, similar to varicose veins in the legs. It affects about 15% of men, usually on the left side, and often starts in adolescence.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
Symptoms
- Often no symptoms; it is found on examination.
- Heaviness or a dull ache in the testicle that worsens on standing or exertion and eases when lying down.
- Twisted veins seen or felt above the testicle.
- The affected testicle being smaller than the other.
- Difficulty conceiving or an abnormal semen analysis.
Grades
- Grade 1: felt only when straining (Valsalva manoeuvre).
- Grade 2: felt when standing, without straining.
- Grade 3: visible.
Diagnosis
- Clinical examination standing and lying down by a urologist.
- Doppler ultrasound to measure the veins, blood reflux and testicular size.
- Semen analysis when planning a family or when conception is delayed.
When does a varicocele need treatment?
- Reduced fertility with a palpable varicocele and an abnormal semen analysis.
- Persistent pain affecting daily life.
- A smaller testicle, especially in adolescents.
Varicoceles that cause no symptoms and do not affect fertility can usually be monitored.
Treatment methods
- Microsurgical varicocelectomy through a small incision below the groin.
- Laparoscopic varicocelectomy.
- Embolisation to close the vein from inside in some cases.
In many men semen quality improves within several months of treatment; the doctor discusses the right method for each case.
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Frequently asked questions
Is a varicocele dangerous?
Usually not, and many men need no treatment. It can be linked to reduced fertility, a smaller testicle or pain, and then treatment is discussed.
Does a varicocele cause infertility?
It is one of the most common treatable causes of reduced male fertility, but not every man with a varicocele is infertile. A semen analysis helps assess this.
Can a varicocele be treated without surgery?
Medicines do not make a varicocele go away, but varicoceles without symptoms or fertility problems can simply be monitored. Embolisation, closing the vein from inside through a catheter, is an alternative to surgery in some cases.
What is the best operation for a varicocele?
Microsurgical varicocelectomy is among the options with the lowest rates of recurrence and complications; the doctor chooses the right method for each case.
Book an assessment
Prof. Al-Samarrai and Dr. Amer Mousa assess varicoceles with examination, Doppler ultrasound and semen analysis, and explain whether treatment or monitoring is right for you.
This information is for health education and does not replace a medical examination. See our medical content policy.