Varicocele

A common scrotal condition characterized by elongation and enlargement of the network of veins leaving the testis which join to form the testicular vein.

(This venous network is called the pampiniform plexus.) A varicocele develops because of defective valves that normally let blood flow in only one direction, away from the testicle.

A varicocele typically appears bluish through the scrotum and feels like 'a bag of worms.' It becomes smaller or disappears when the man lies down.

Newer tests that may be used to confirm the diagnosis include scrotal ultrasound, Doppler stethoscope, and technetium isotope study.

About 15% of all men have a varicocele.

It can cause pain and discomfort.

The treatment is usually to ligate (tie off) the enlarged veins.

Since men evaluated for infertility tend more often to have a varicocele, it may be associated with infertility.

However, vein ligation does not appreciably increase fertility.

The problem may be that the varicocele sometimes damages the testis and that damage is irreparable.

The Roman writer Celsus (1st century AD) recognized and described the varicocele: 'The veins are swollen and twisted over the testicle, which becomes smaller than its fellow in as much as its nutrition has become defective'.