Varicocele

Varicocele: Treatment, Causes, Symptoms

Varicocele is a male infertility condition where the veins within the scrotum become enlarged and swollen, similar to varicose veins in the legs. This abnormal dilation of the veins, called the pampiniform plexus, can increase scrotal temperature and impair sperm production and quality, leading to male infertility.

Varicocele is one of the most common reversible causes of male infertility, affecting 15% of all men and up to 40% of men with infertility issues.

What are the symptoms of varicocele?

Swollen or enlarged veins in the scrotum (often described as a “bag of worms”).
Dull, aching pain in the scrotum, especially after prolonged standing or physical activity.
Testicular shrinkage (atrophy) due to long-term exposure to excess heat.
Infertility issues, including low sperm count, poor motility, or abnormal sperm shape.
Asymptomatic cases – Many men with varicocele have no noticeable symptoms and only discover it during a fertility evaluation.

What are the causes of varicocele?

Faulty vein valves cause blood to pool, leading to enlarged veins.
Increased scrotal temperature from poor circulation affects sperm production and motility.
Hormonal imbalance from reduced testosterone impacts sperm health and sexual function.
Anatomical factors, especially on the left side, lead to higher pressure and more varicocele cases.

Varicocele Treatment

1. Lifestyle Modifications & Pain Management
• Wearing supportive underwear (scrotal support) reduces pain.
• Avoiding prolonged standing or heavy lifting prevents worsening.
2. Varicocelectomy (Surgical Repair)
• The surgeon ties off the affected veins, redirecting blood flow to healthier veins.
• Done via open surgery, laparoscopic surgery, or microsurgical varicocelectomy.
3. Varicocele Embolization (Minimally Invasive Procedure)
• A radiologist inserts a small coil or blocking agent into the affected vein, preventing blood pooling.

Non-Obstructive Azoospermia (NOA) is a male infertility condition where the testicles produce little to no sperm due to sperm production failure. Unlike Obstructive Azoospermia, where sperm is blocked, in NOA, sperm is either absent or produced in extremely low quantities.

NOA affects about 1% of all men and 10% of infertile men.

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Signs of Varicocele: