Varicocele is a common condition characterized by the enlargement of the veins within the scrotum, similar to varicose veins in the legs. This condition is significant because it is one of the leading causes of decreased sperm quality and impaired fertility in men. It typically affects the left side of the scrotum and can have a substantial impact on a man’s fertility.

What Is Varicocele?

Varicoceles are abnormal enlargements of the pampiniform venous plexus, a network of veins in the scrotum. These veins are responsible for draining blood from the testicles. When these veins become enlarged, they can cause pain, and swelling, and have a negative impact on sperm production and quality.

Causes of Varicocele

The exact cause of varicoceles is not entirely understood, but it is believed to be related to the failure of valves within the veins. This valve failure leads to blood pooling and increased pressure in the veins, causing them to enlarge. Factors like standing for long periods or physical exertion can exacerbate the condition.

Symptoms and Detection

Many men with varicoceles do not experience any symptoms and are often unaware of the condition until fertility issues arise. When symptoms do occur, they can include a dull, aching pain in the scrotum, a feeling of heaviness or dragging in the scrotum, visibly enlarged or twisted veins in the scrotum, and at times, shrinkage of the testicles.

Diagnosing Varicocele

Varicoceles are typically diagnosed through a physical examination, where a doctor may feel a mass of enlarged veins, often described as feeling like a bag of worms. Ultrasound scans are also used to provide a more detailed view of the veins in the scrotum and to measure the blood flow, helping to confirm the diagnosis.

Treating Varicocele

The treatment of varicocele aims to relieve symptoms and improve fertility. Options include surgical procedures like varicocelectomy or laparoscopic surgery, where the affected veins are clipped or tied off to redirect blood flow. Embolization, a less invasive procedure, involves inserting a catheter into a vein and blocking the enlarged veins using coils or balloons.

Prevention Strategies

There are no definitive ways to prevent varicocele. However, wearing supportive underwear to reduce scrotal sagging, maintaining a healthy weight, and avoiding activities that put excessive strain on the area can be helpful.


Varicocele is a treatable condition, and many men who undergo treatment see improvements in sperm quality and, consequently, fertility. With proper medical care and lifestyle adjustments, the impact of varicocele on fertility can often be significantly mitigated, allowing many affected individuals to pursue their goals of fatherhood.