A guide to varicocele: Is it serious?

In this informative article, highly respected consultant paediatric urologist and paediatric and neonatal surgeon Miss Marie-Klaire Farrugia gives an all-you-need-to-know guide about varicocele, which can cause pain in the testicles and affect development in young boys. The revered specialist also details when treatment is indicated and who is most commonly affected by varicocele.

What is a varicocele?

A varicocele is a swelling of the veins that surround the testicle, more commonly, the left testicle.

Who is usually affected by varicocele?

It commonly affects teenage boys. The blood supply to the testis comes from the abdomen, and the gravity effect could result in the veins becoming more prominent. Very rarely, a kidney tumour could be compressing the vessels in the tummy, resulting in a varicocele. This could happen at any age.

How serious is varicocele?

An ultrasound of the renal tract and testis would be the first investigation, to ensure there is no kidney tumour, and to check the size and volume of both testes.

Varicoceles are usually harmless, and do not cause symptoms. Occasionally, boys describe a “dragging” sensation in the scrotum, especially during sports. Large varicoceles may affect testicular growth, which is why we commonly monitor them by checking testicular volumes periodically. In this situation, future fertility potential in the affected testis could be disturbed.

When is treatment indicated?

Treatment is indicated when the varicocele is causing pain, or if it affects testicular growth. Options include:

• an interventional radiology procedure under local anaesthetic, whereby the veins are injected with small coils or foam to decompress them
• a surgical procedure under general anaesthetic, whereby the veins are clipped or tied inside the abdomen (usually by key-hole surgery)

The most common risk of this surgical procedure is a post-operative hydrocele (fluid around the testis).

What is recovery time like?

Both procedures are day-case procedures and recovery is quick. Recurrence is unusual, but if a hydrocele develops, then that may also require intervention.

If you are concerned about varicocele and wish to schedule a consultation with Miss Farrugia, you can do so by visiting her Top Doctors profile.