Varicoceles

Testicular varicose veins are a common condition that does not necessarily produce any symptoms. A varicose vein is understood to be a dilated vein which would normally transport the blood to the heart. For various reasons, the venous valves do not work properly, causing backflow of blood and dilation of the veins along the spermatic cord and the testicles. The medical term for testicular varicose veins is “varicoceles”.

We know from medical examinations for military service that about 15% of the young male population suffer from varicoceles. Because of the varying courses of the blood vessels, these most commonly become apparent on the left side.

In most cases, varicoceles do not produce any symptoms and, depending on the degree of severity, are only palpable or visible.
The following degrees of severity are distinguished:

• Grade 0: only visible on ultrasound, not palpable
• Grade 1: only palpable when increasing the pressure in the abdomen by pressing the same way as for defecation (referred to as Valsalva manoeuvre)
• Grade 2: palpable at rest (i.e. also without pressing)
• Grade 3: visible varicoceles, often described as looking like a “bag of worms” in the scrotum

Typical symptoms of varicoceles include pain that often occurs during sporting activities and spreads downwards from the groin. Some patients perceive pronounced varicose veins as being cosmetically undesirable.
Varicoceles may ultimately also affect fertility. Regarding infertility, this aspect is discussed particularly often in cases where varicoceles are present.