When 16-year-old Jake kept his appointment for a physical before joining his high school football team, he was taken off guard by a couple of the doctor’s questions.
The physician wanted to know if he ever felt a sensation of heaviness in either of his testicles. After Jake nodded his head in agreement, the doctor asked, “On the left side?” The would-be halfback wondered if the older man was a mind reader.
What it is
A varicocele is an enlargement of the veins along the spermatic cord in the scrotum, the bag that holds a male’s testicles, according to the Mayo Clinic. In some respects, it resembles a varicose vein in the leg.
Sometimes this condition has no signs or symptoms. Some men, however, might feel pain varying from a dull feeling of discomfort or heaviness to a sharp sensation. The discomfort typically increases during sitting, standing, or physical exertion over an extended period of time and tends to worsen as the day progresses. It’s often relieved when a man lies on his back.
Development of a varicocele is most common between the ages of 15 and 25. Most of them appear on the left side of the body, though it’s possible to experience them in both testicles. MedlinePlus reports that varicoceles are often linked to male fertility problems because they can affect sperm production.
A varicocele typically develops slowly. If one appears in an older male, doctors will suspect an underlying kidney tumor, which can block blood flow to a vein.
Development of the condition begins when valves inside veins along the spermatic cord prevent blood from flowing through them as it should. The blood eventually backs up. This leads to swelling and widening of the veins and a varicocele.
The Mayo Clinic states that doctors are uncertain as to exactly what causes the valves to malfunction. They do know that puberty marks the development of many varicoceles and believe that the reason they normally occur on the left side of the body is probably because of the position of the left testicular vein.
A varicocele in only one testicle can have an effect on sperm production in both.
When a varicocele develops, the affected testicle shrinks and starts to soften. The increased pressure in the veins and exposure to toxins can cause damage to the testicle. The exact reason for varicocele infertility remains undiscovered. Experts postulate, however, that the effect on sperm quantity, quality, and motility might be caused by an elevated temperature from blocked blood flow.
For many men whose varicoceles cause them no difficulty, no treatment is necessary. Doctors often recommend surgery if one testicle atrophies or becomes smaller than the other. How a surgical repair affects fertility problems remains unclear, according to the Mayo Clinic. Many physicians are reluctant to recommend surgery during adolescence.
The most common procedure is an open surgery scheduled on an outpatient basis with anesthesia. While some surgeons use a laparoscopic procedure, it’s far less common. A percutaneous embolization uses coils or balloons passed through a tube into a vein to interrupt the blood flow and repair the varicocele. However, this procedure can take several hours to complete and isn’t widely used.
Men with varicoceles might be able to relieve some of the discomfort with over-the-counter medicines like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Wearing an athletic supporter also reduces pressure.
Mayo Clinic site