Varicose veins in the testicles (varicocele)

A varicocele can be either primary (idiopathic) or secondary (symptomatic). The primary form is usually genetic and results from a weakness of the venous valves or an unfavorable orifice of the left testicular vein into the left renal vein, which obstructs the blood flow and leads to a backflow. Secondary varicoceles are caused by an obstruction in the outflow of blood, such as a tumor, which impairs the return flow of blood.

• Pain or heaviness in the scrotum
• Swelling or visible enlarged veins in the scrotum
• Changes in the size or shape of the scrotum
• Possible impairment of sperm quality

Diagnosis is made by a physical examination and an ultrasound scan (Doppler sonography) to check the extent and blood flow in the affected veins. A sperm analysis may also be necessary to assess the effects on fertility.

• Conservative therapy: In mild cases, supportive measures such as wearing tight underpants can provide relief.
• Sclerotherapy: Injection of a sclerosing agent to close the affected veins.
• Surgical procedures: A varicocelectomy, in which the affected veins are surgically tied off and severed.
  • Severity of the procedure: Moderate, usually requires a short recovery time.
  • Duration of the procedure: Approximately 1 to 2 hours.
  • Aftercare: Cooling of the scrotum and pain medication, rest period of about one week.
  • Probability of success: High, with a significant improvement in symptoms and sperm quality.

There are no specific measures to prevent varicoceles. However, a healthy lifestyle and regular urological examinations can help to detect and treat possible complications at an early stage.