• What are the signs and symptoms of a varicocele and what is the effect on fertility?

A varicocele is an enlargement of the veins in the scrotal sac. It may become quite large but even just a small varicocele is enough to affect male fertility. A varicocele is a common cause of lower sperm counts and poor sperm quality in men. It represents around 10-15% of male fertility problems.

Most men with a varicocele will have no symptoms. Men should know how to self-examine their testicles to make sure that they don’t a varicocele or any other lumps or bumps of concern. A varicocele can be quite subtle but an enlarged scrotal sac with what may feel like a “bag of worms” is described classically due to the enlarged veins surrounding the testicle. You may feel a dull ache or notice a heaviness on one side.

  • How is it diagnosed?

Self-examination and awareness is essential if men are to successfully find and diagnose a varicocele. This can be problematic as many men might be aware of a difference felt in the scrotum but choose to ignore it and not explore it with a doctor. If the varicocele is left untreated or undiagnosed for long periods of time the overall testicular temperature may rise, causing testicular atrophy and damage to sperm production and quality.

  • How is it treated?

A varicocele is often left untreated. It is commonly ignored by many men unless they tend to have fertility problems. Surgery to treat a varicocele will be performed by a Urologist and there are different surgical approaches to repairing a varicocele. In general 3-4 months after a varicocele repair a semen analysis test should be checked. It can take six months to a year after the repair to see an improvement in the semen parameters.