You’ve likely heard of varicose veins–twisted, enlarged veins that commonly appear in the legs and feet. But what you may not have heard of is a varicocele, which is the result of testicular veins. 

What is a Varicocele?

The formation of a varicocele can result from vein abnormalities that restrict blood flow in a testicle. This restriction can cause swelling and result in decreased sperm concentration, decreased sperm motility (movement), and decreased sperm morphology (form or structure).

Most varicoceles develop over time, with most cases (10-15%) presenting in boys during puberty. However, as many as 15% of men have varicoceles. Additionally, it is the leading cause of male infertility.


Individuals may experience symptoms, however, they may also be asymptomatic (without symptoms). Some symptoms may include:

  • Discomfort in the scrotum
  • Swelling in the scrotum
  • Dull pain in the scrotum
  • Problems with fertility
  • Testicular atrophy (shrinkage)
  • A mass or lump in or on the scrotum

Diagnosis and Treatment

Scrotal swelling or testicular enlargement should be evaluated by a urologist to determine its cause and to rule out other medical conditions. A physical exam by an experienced urologist is the most reliable way to rule out a varicocele. If the physician needs additional information, he or she might order ultrasound imaging of the scrotum.

If a varicocele is diagnosed, it is graded based on severity which will guide the recommended treatment plan. 

If a man is not experiencing fertility issues, shrinkage of the testicles or pain, the physician may recommend watchful waiting–or observing the condition without taking action. 

For those who are symptomatic or considering infertility treatments, varicocele repair may be recommended. There are several methods, all of which can be done on an outpatient basis: 

  • Embolization: This minimally invasive procedure uses an imaging-guided catheter to stop the growth of the varicocele.
  • Laparoscopic Surgery: This procedure requires a small incision in the abdomen through which a laparoscope can be inserted to locate and repair the varicocele.
  • Open Surgery: With open surgery, an incision in the abdomen is also made. A microscope is inserted to identify the location of the veins that produce the varicocele. They are then cut to eliminate blood flow and stop the varicocele’s growth.

Schedule an Appointment

At Alliance Urology Specialists, our goal is to provide the highest level of specialized urology care. Our board-certified physicians specialize in the diagnosis and treatment of a variety of urological conditions, including varicoceles. 

If you discover a lump in the scrotum, contact Alliance Urology Specialists in Greensboro at (336) 274-1114 to schedule an evaluation with one of our urologists.