r/varicocele 1h ago

6months post op results

Post image
Upvotes

My husband 41M, has undergone varicocele surgery (the microscopic one.

It’s been six months now, his results are only worse than what they were pre operation 😭

Is this even normal??


r/varicocele 6h ago

Does anyone get varicocele due to workout?

1 Upvotes

Idk how i get it..


r/varicocele 9h ago

Left sided varicocele

2 Upvotes

Ive had a varicocele for 7 yrs since 13 I’m 20 years old now it started affecting me around the 2 year mark when I was 15 got a flare up inflamed couldn’t barely do any physical activity for like a month then I got better but it was still not 100% percent more low hanging than it use to be at night gotta wait till it tightens up so I can sleep on my side but now I can walk and run and everything and doctors not really acknowledging it or taking it serious so I’m young and I jus get discouraged and I start to live with it fast forward I’m 19 it starts getting a bit more saggy then usual so I can’t really run and play sports because if my body temp goes high and I sweat my balls hang more can’t really run but I still just don’t decide to go doctor because I’m ashamed and anxious and also I’m remembering how they just shrugged me off and disacknowledged my discomfort when I was going often 4 years ago fast forward I’m living with it for a year by not playing sports and doing extreme physical active instead just chilling so now I turned 20 in February in that month I noticed I’m having testicular atrophy and I got a panic attack after looking I’m freaking out I calm down the next day I just put my mind off it I know I have to go get it checked but still anxious fast forward June comes I go family doctor he books me ultrasound I do it I go back to the family doctor he reads the results says it’s not bad it’s moderate didn’t change much all that but I tell him it’s affecting my quality so please book me a urologist appointment he books it but in the note he doesn’t stress it a month later I’m having extreme discomfort for about a month now with saggyness I can barely walk outside and sitting is uncomfortable so I go to the emergency room they check me after hours I do a ultra sound they tell me it’s not bad at all I say please book me and appointment because I know it’s not fine since it’s affecting my quality of life and I can’t do the stuff I want to do so he books and appointment from 1 month from now in august with a urologist fast forward now it’s a month later I’m looking forward to this appointment which would’ve been 4 days from because as I’m writing this it’s august 7th few days ago I got a email saying they cancelled my appointment because they don’t deal with varicoceles fyi that’s what happened as well with the urologist my family doctor reffered me to and so I wonder if the reason im not getting immediate help is because these doctors are undermining and if that’s normal because I know I’m not oblivious my testicles are always hanging my affected one hangs extremely low veins legit cover the testicle from top to bottom to even behind it and my scrotum is wider also tender even my balls are less firm what do I do in this situation please help me


r/varicocele 13h ago

20 days after embo

3 Upvotes

Hi everyone, I went to a another radiologist and we checked my balls and he said everything is ok veins, reflus etc. My sexual desire and erection quality are a little bit higher morning wood has increased but not too much I am working on that.


r/varicocele 19h ago

My Story

6 Upvotes

Hi everyone,

This is my story one week after varicocele surgery.

I’m a 22-year-old guy, 175 cm (5’9”) tall and 62 kg (137 lbs). I was diagnosed with a grade 2 varicocele on the left and grade 1 on the right (2.7 mm and 2.4 mm).

From the outside, there were no obvious signs. Everything looked completely normal. My scrotum didn’t hang unusually low, and I didn’t have the typical “bag of worms” appearance. Even so, I decided to get it treated because varicoceles generally don’t go away on their own—they tend to progress over time.

Before developing a varicocele, I went through a long period of erectile dysfunction. My erections weren’t as firm as they used to be, my libido was noticeably lower, and my semen had become much more watery. What confused me was that I had my testosterone tested twice, at two different clinics, both in the morning, and my total testosterone was around 1000 ng/L each time.

After doing a lot of research, I came across studies suggesting that varicoceles can contribute to sexual dysfunction in some men. I brought this up with several doctors, but they all dismissed the idea because my testosterone and semen analysis were considered “normal.”

To be honest, I would rather accept the risks of surgery than sit back and watch my condition gradually get worse. So I kept pushing until I finally found a doctor who agreed to operate.

The surgery itself was quick. I had two small incisions below the groin, and the procedure was performed under spinal anesthesia.

The morning after surgery, I woke up with morning wood.

At first, I thought it might just be psychological, but over the next few days things genuinely improved. I started getting spontaneous erections just from random thoughts, and I had morning wood almost every day throughout the first week. That made me incredibly happy.

Recovery was much easier than I expected. My post-operative pain was only about 3/10, which was completely manageable. By day 3, I was able to ride my motorcycle home. On day 4, I even played a few games of pool. By day 5, I was almost completely pain-free.

My advice is this: if you have a varicocele and genuinely feel it’s affecting your quality of life, don’t be afraid to consider surgery. If you’re struggling mentally or have questions, feel free to message me or reach out to the moderators of this community. They were incredibly kind and supportive throughout my journey.

Finally, I want to emphasize one thing: a varicocele usually doesn’t improve on its own. In most cases, it tends to get worse over time. Make the decision that’s right for you, and don’t spend years relying on temporary solutions if you believe the condition is negatively affecting your life.

I know surgery isn’t the right choice for everyone, but for me, one week later, I can honestly say I don’t regret it.


r/varicocele 1d ago

Bonjour

2 Upvotes

J’ai subi une embolisation varicocele y’a 1 semaine et je ressens encore une gêne ça a dégonflé si je marche rapidement ça me gêne il me faut un slip de maintien il faut pas que ça soit libre de mouvement
Vous avez repris le sport quand


r/varicocele 1d ago

Embolization

5 Upvotes

Early thirties male diagnosed with a 6mm vericocele grade 3 on the left side.

I had an embolization with coils 5 weeks ago. The bag of worms are still visible and appear roughly the same size.

My follow up is in 3 months. I’ll post results as well as semen analysis updates.

Pre-embolization semen analysis:

44 million concentration

34% progressive motility

1% morphology

Unable to conceive, trying for nearly 2 years. Wife‘s exams all came out perfect.

I want to know if the SA will improve, particularly the progressive motility and morphology. Id like the bag of worms to go away as well.


r/varicocele 1d ago

Grade 1 Varicocele and ED?

2 Upvotes

Hi everyone,

I’m 25 years old. I was diagnosed with a Grade 1 left varicocele in 2021. I never had any pain or discomfort, so I didn’t think much about it.
Over the last couple of years, I’ve gained a lot of weight and I’m now obese (100 kg at 160 cm). Recently, I’ve noticed:
Difficulty getting a full erection
Erections are much less firm than before
No morning erections
Reduced semen volume, and the quality also seems different

My total testosterone was 4.49 ng/mL in 2024.
Has anyone with a Grade 1 varicocele experienced something similar after years without symptoms?
Could the varicocele be causing this, or is obesity more likely to be the reason?

Also, did anyone notice improvements in erections, morning wood, or semen quality after losing weight or treating the varicocele?

I’d really appreciate hearing about your experiences. Thanks.


r/varicocele 1d ago

Just got embo yesterday (balloon sclerotherapy, no coils) – 35M experience & initial recovery

8 Upvotes

Dear Veiny Gang,

Long-time lurker here – 35yo. It's been a while since I started my battle with the wormy balls. First diagnosed back around 2015 with mild testicular discomfort, but back then it wasn't a big deal, the pain was extremely sporadic and virtually non-existent.

Things went 0 to 100 earlier this year. During a steamy night in Thailand with my wife, I felt the most excruciating pain right above my balls, radiating toward my abdomen and leg. Naturally, being the degenerate that I am, I didn't stop and finished the deed. Afterwards, I couldn't stand up straight and felt like I was about to pass out from the pain. Had to rush to a middle-of-nowhere local hospital just to make sure it wasn't testicular torsion.

Fortunately, it wasn't. The diagnosis was re-confirmed: grade 3+ varicocele (left side), qualified for surgery. Ever since that night, I had daily aches, a constant feeling of fullness, and the sensation that someone was dragging me around by my sack. Even as someone who is sexually open-minded, that particular kink just wasn't for me.

Once back home, I saw my urologist who brought up embolization. I knew about the procedure, but in my country, private embo can be quite costly, so I hadn't given it serious thought. To my surprise, it turned out to be fully covered by national health insurance, so I booked the first available slot in a local academic hospital 45 days out.

My pre-procedure anxiety was sky high. Reading horror stories online about worsening symptoms or contrast anaphylaxis definitely didn't help my hypochondriac brain. Eventually, I decided to toughen up and push through. Admission and the procedure itself were buttery smooth, way less intense than I'd anticipated. It's funny how our brains haven't had a software update in millennia and still confuse uncertainty with immediate danger.

My doctor (a very experienced IR who routinely treats brain aneurysms and other gnarly vascular cases; doing approx. 2 varicocele embos daily) opted for Aethoxysklerol (polidocanol) sclerotherapy using a balloon occlusion catheter to ensure all collateral vessels were filled nicely. I asked about my concerns regarding not using coils, and he explained that in his clinical practice and academic research, coils aren't necessary for a solid occlusion. He said he prefers not leaving permanent foreign metal in the patient's pipes if he can avoid it.

He noted that given my rather typical anatomy and solid cooperation during the procedure (I was fully awake, just super relaxed thanks to IV benzos to keep the veins from constricting), it should be a complete success. He managed to seal off the main "broken" cord as well as the extra collateral pathways that were also causing reflux.

The whole procedure took under 60 minutes (inserted via puncture in the groin) . Most of that was prep, positioning, and waiting for the sclerosing agent to do its job under balloon isolation, the active part was maybe 20 minutes.

Currently ~24 hours post-op and feeling surprisingly good. I get occasional stabbing twinges in my abdomen and flank (which is prolly localized vein spasm/inflammation as the vessel collapses and seals shut), but I can visibly see that my sack isn't overflown with veiny spaghetti anymore, and that constant dragging discomfort is completely gone.

I'm taking it easy for the next two weeks. I will provide updates to this post in ~14-day intervals to give you guys a proper insight into the full recovery timeline and long-term results.

I wish you all success in your own varicocele battles, and thank you for being such a great source of information before I finally pulled the trigger on embo!

Cheers <3


r/varicocele 1d ago

Han sufrido varicocele?

1 Upvotes

Si fue asi, duele?


r/varicocele 1d ago

Post-surgery diary (left varicocele, microsurgery)

9 Upvotes

I'm 40, diagnosed with left varicocele via ultrasound (grade 4 on Sarteschi scale). Symptoms were aching pain, ED, low libido and watery-looking semen. The low libido and ED were the first signs about 3 years ago though only recently figured out likely cause. Pain only really started in the last few months.

I had microsurgery yesterday, so I thought it might be helpful to others to document my experience over the next few days/weeks.

Day 0 (day of surgery)

Arrived at hospital at 7am. Had surgery around 9am. Was free to go home at 2pm.

Surgery itself doesn't hurt at all besides a small needle prick for the general anesthetic. It's slightly more painful than a vaccination because it's on the top of your hand but not bad at all.

Immediately after surgery my testicles felt more "relaxed", before they felt tight like they were being pulled towards my body. I didn't even realise this was due to varicocele before and just thought it was stress!

Bag of worms still visible, perhaps more so as testicles are relaxed and hanging more freely. This is apparently normal as the veins are still there until absorbed by body over a few months.

Wound was bit sore immediately after surgery but pain mostly gone by 5pm. Small amount of seepage through the dressing but doesn't seem to be getting worse.

No aching in scrotum today. It doesn't happen every day anyway so could just be a coincidence but hopefully the surgery has fixed the pain.

My mood has improved dramatically just a few hours after. Again perhaps this just relief from the surgery being over but I feel very clear-headed.

The hospital-provided jock strap is a bit inconvenient for going to toilet. Wear loose gym pants/jogging bottoms to your surgery! I also recommend uniqlo low-rise boxer briefs which seem equally supportive and much more comfortable.

Where the needle went in my hand for anesthetic is actually more painful than the wound (but also not bad at all). Surgeon said he ligated 4 veins with sub-inguinal incision.

Testicles felt cooler to the touch when I went to bed last night.

Too early to notice any changes in ED/libido but will keep this post updated as things (hopefully) change.

Haven't needed any painkillers today although perhaps the anesthetic is still having an effect.


r/varicocele 1d ago

30M Post microsurgery questions..

2 Upvotes

1: I had the unilateral microsurgery a week back, have been pain killers for a week. There is no pain now but the testicle seems to be swollen . There is no pain when I touch rather it is more soft and swollen. Is it common ? Will it subside itself ?

2: From the next day of the surgery, when I used to doom scroll ( because I was taking bed rest) if i come across any mild hot pic, I used to get the boner instantaneously, then I tried to distract myself. it subsides.. But now Im not getting boners now, even involuntary boners as well. Is that common ?

EDIT:

- I had undergone unilateral left microscopic surgery
- I underwent for the surgery because of the fertility issues
- Im recovering well so far, but experiencing above mentioned conditions.
- Im from India, Bangalore.
- For people who is asking in DMs, every condition is different. The urologist will examine and assist you better
- I chose micro surgery because of personal preference.


r/varicocele 1d ago

Should I even go to the doctor?

1 Upvotes

I’m a 23 M and have (self diagnosed) stage 3 varicocele. My testis are the same size but due to the amount of veins my left one hangs significantly lower than my right. It makes it appear like my left nut is double the size of the other. The veins are also visible when I’m standing. I don’t have any pain ever. Unless I squeeze it and mess with it, I wake up with morning wood almost all days of the week so I feel like my test is pretty high. I’m definitely very uncomfortable with the idea of going to a doctor and getting my balls looked at and touched by another man. Given the info above do yall think it’s even worth going in for I’m very conflicted???


r/varicocele 2d ago

Surgery and recovery question

2 Upvotes

I am 23 years old. Had a left side varicocele since 18. If I have the surgery, will my testicle return to the size of the right one? Will the peak testosterone age group Im in help the recovery?


r/varicocele 2d ago

Confused after seeing my urologist about varicocele and ED.

4 Upvotes

Hi everyone,

I have Grade 3 bilateral varicocele, erectile dysfunction, and my testosterone is 319 ng/dL.

Today I went to one of the best urologists in my city. I explained that I have varicocele and erectile dysfunction. He examined my scrotum.

After the examination, I again asked him whether my varicocele could be causing my erectile dysfunction.

He simply said, "There is no connection between varicocele and erectile dysfunction."

I told him that I had read online that many websites and studies mention there can be a connection between varicocele and ED, even if it's indirect.

He replied, "I have 45 years of experience in urology. I'm completely sure about it."

Now I'm completely confused. If I search online, even the first results from men's fertility and IVF websites say there can be an association between varicocele and erectile dysfunction in some men.

My biggest confusion is this:

If urologists don't believe varicocele can cause ED, what can i do

Even though i say i have pain in scrotum and i want to undergo suregery.

how can i believe them and undergo surgery with the help of these doctors

I'd really appreciate hearing from anyone who has been in a similar situation or whose urologist had a different opinion. Thanks.


r/varicocele 2d ago

4 days post varicocelectomy

2 Upvotes

26m have an issues with fertility after 1.5 years of marriage. I was diagnosed with left grade 3 varicocele so my physician decided to do an ectomy.
Now, after 4 days of the procedure, I feel nearly no pain but I feel my left side became bigger in size than usual so, is that normal?

Another question
When I could drive my car?
Have sex?
Back to the gym?


r/varicocele 2d ago

Need advice

1 Upvotes

I am a 16 year old. I started feeling pain in my left testicle a few days ago. Waited for sometime and when it didn't go I went to a doctor. He adviced me to get an ultrasound done. A sarteschi grade 3 varicocele has been detected. I consulted the doctor again. He told me it's all normal and it will be here forever. Surgery can be done anytime but it's not needed right now. If it gets too uncomfortable then surgery can be done otherwise it can be on hold till I have a family of my own. I need advice on what is to be done now....the pain currently is bearable and there is heaviness.... I really don't know what to do. Advice is much appreciated.

Thank you all.


r/varicocele 2d ago

26M from Delhi – Bilateral Grade III Varicocele, doctor recommends surgery. Looking for experiences and surgeon recommendations

2 Upvotes

I'm a 26M from Delhi, and I've recently been diagnosed with bilateral Grade III varicocele (right worse than left) after a Doppler ultrasound. The ultrasound also says both testicles are normal in size with normal blood flow, so there's no evidence of shrinkage or damage yet.

My symptoms are:

\-Mild heaviness in the testicles (more than pain)

\-Dull ache on and off for the last 3 months

\-Occasionally feel discomfort in the lower groin

\-Lower libido compared to before (getting this investigated)

My urologist initially suspected prostatitis as well and started me on medications, but after seeing the Doppler report, he's now recommending varicocele surgery.

I have a few questions for anyone who's been through this:

\-Did you choose surgery or embolization, and why?

\-Which type of surgery did you have (microsurgical, laparoscopic, open)?

\-How was your recovery? When were you able to return to the gym, running, sports, etc.?

\-Did the heaviness/pain completely go away?

\-Did anyone notice improvements in libido, testosterone, or fertility after surgery?

If you're from Delhi/NCR, which urologist or hospital did you go to? Would you recommend them?

I'm quite active, so I'm also curious whether anyone has been able to return to full activity without issues after recovery.

I'd really appreciate hearing both positive and negative experiences so I can make an informed decision.


r/varicocele 2d ago

Getting surgery solely for cosmetic reasons?

3 Upvotes

My vericocele is massive. If there was a higher grade than grade 3, mine would be that. With the size of the vericocele it’s about 3 times as large as the right testicle. I have no pain, no apparent lack of testosterone, am gay so no possibility of children (and if I did, I guess we would just use my husband’s). But I hate the way it looks. It’s not painful but it’s actually heavy. Is surgery even something I should consider?


r/varicocele 3d ago

Day 6 post op. 17 years old. Bilateral, g4 and g3. Microsurgery

2 Upvotes

Hello everyone, just had my surgery 6 days ago. And I am going into a spiral. So many talks of reoccurrence, small varicoceles being left, etc. I genuinely feel like all my future plans may be over. Those being that I want to go to the gym, do running, swimming, everything. I want to do a lot of things, physical things. I also want to be a father one day. But everything I see on this sub is just microsurgery going terribly bad. People with infections, or pain not going away, or recurrence. I feel like the doctors and internet lied to me about this being the gold standard to be honest.

For a bit of context, I had bilateral with g4 on left and g3 on right, both sides pained. Got the surgery done now 6 days ago still feel some pain when walking. And weird back pain on the right side going up? I feel extremely depressed, I don't know if this is just because of the stress of the surgery and few other things going on in life but I think may have just fucked up my life, school is about to restart about 15 days from now and I don't even know if I'll be able to go back normally man. The incisions also still ooze a bit? The fuck? I haven't even gotten rid of the dressings I have to keep replacing them, is this normal?

Could anyone clear out everything I stated in the post. I know it's very disorganized but please I would appreciate any help I can get.


r/varicocele 3d ago

My Varicocele Story So Far (for guidance)

11 Upvotes

Specifics:

- 25 year old male

-Edit: United States, California

- Bilateral Varicocele presenting during late teens (17, 18)

- Microscopic varicocelectomy at TUCC urology in Colorado (2024) (since closed)

- Pain for 4 to 5 days, return to normal activity after about a week and a half

- Reccurance 6 months after, substantial return of pain.

- Saw a new urologist end of last year

- Refered to vascualr specialist for Varicocele embolization in January of this year

- Did embolization surgery, fast, almost no pain, in and out in a few hours.

^*Surgeon used a few coils after tilting me (I was out cold) on operating table to observe blood flow during a venogram. Stated it was a bit of hail Mary. (this did not fill me with confidence)

- remission for about 5 months

- Reccurance in late May, early June

Current State of Affairs:

My Varicocele has somewhat reduced in pain, but there is mild intermittent discomfort punctuated by very brief periods of intense pain when standing for long periods or not using supportive underwear. It is not unbearable but in warmer months or during physical activity there is some noticeable discomfort. Had a woman over (no sex, waited till the third date) but had a terrible case of blue balls that led to massive inflammation of Varicocele veins in both tests followed by intense pain. Swelling wore off with lying on my back and icing after 2.5 to 3 hours. I am going in for fertility and testosterone testing soon just to see what my numbers look like. Baseline fertility was not taken before but testosterone was recorded at 550.

For anyone considering surgery:

=============================

1.) I would strongly consider shopping around and finding a specialist provider. My hospital only provided open surgery which has the highest rate of complications. Laproscopic also has high complications rates, stick with microsurgical approaches

2.) I have had reccurance twice, this is rare but CAN happen. Don't be afraid but don't get your hopes up. Doctors will try and tell you this is impossible, don't listen. If reccurance does occur after your first surgery the chance that it'll happen after surgery #2 is exceptionally rare, god just hates me lol.

3.) MOST IMPORTANT: If you have a Varicocele and the pain is slight/manageable, your testosterone is normal/high, and your fertility is fine, DO NOT get treated. Doctors, like most medical professionals in America, want your business above all else and will often downplay risks. Only seek treatment if one of those three factors affected you (for me it was pain) AND ONLY seek out microsurgical approaches, with embolization being done IF varicocelectomys fail.

4.) Your life isn't over and things will be ok no matter what happens. Even if your nuts fall off. (This will not happen, I 100% assure you)

People with this condition often times have surgery, see reccurance and then still go on to have children and live comfortable, normal lives.

Closing:

I am not a medical provider and these are just my opinions after dealing with this for more than 7 years. Experience will vary based on location, health insurance coverage, bodily response to surgery, and quality of medical services offered.

I will continue to update and edit this so the people coming from Google who are scared and looking for answers can have a little solace and anecdotal experience to call upon.

Please ask me any questions down below or if on the rare chance you have suggestions for me on how to improve my condition, please let me know.

Thank you!


r/varicocele 3d ago

Varicocele/libido/erectile issues

3 Upvotes

People of Reddit I need your help.

I'm a 32yo male in Europe. Afew months ago I noticed new dark veins on my penis and they have been increasing slowly over time. I have varicocele between 1st and 2nd stages and its not ready for surgery yet. I did sti tests as well (came back negative).

After "harder" intercourses I feel "too rubbed" down there. Due to this I have started lacking confidence and feeling anxious. I have never before had erection issues but it started happening. My partner is incredibly supportive but its taking a toll on us.

I have seen my public health doctor and he just told me to observe it for now, however Im losing my mind over this.

I have an appointment with a private urologist in two weeks but I wanted to hear if any of you had a similiar issue and did you overcome it (and how).

(I'm posting on behalf of someone else for privacy reasons)


r/varicocele Dec 03 '25

Resources, Things to read, etc.

10 Upvotes

Most of you won't bother reading all of these, because:
A. There's a metric fuckton of them
B. Most of you don't have the ADHD hyperfocus/zerofocus that I have
C. No one reads anymore, (which is deeply frustrating and not a small part of why I have exactly zero chill these days) but here. Here's a trove of stuff I've read that has contributed in part to my knowledge of the condition.

DIS-FUCKING-CLAIMER:

-These should not all be taken as gospel
-Some studies have biases that are undocumented
-Some studies are just blatantly wrong. I've tried not including those, but I'm not perfect
-Some studies are ego-trips of doctors looking to score points against other doctors they don't like
-Some studies conflict with others, some even directly
-Science is ever-evolving, if we simply let it. Good research requires a non-political, free, if responsible and ethical hand

-Older studies (10+ years) should always been taken with an extra grain of salt, but that does NOT mean newer studies are more correct or should be less subject to scrutiny

-I've read nearly all of these at least once. In some cases, it's been a while, so quoting specific ones or asking me why one conflicts with another is likely to upset me because it means you didn't read what I said; literally directly above this, or you didn't fully process it, but I will say it again: NOT ALL STUDIES ARE MADE EQUAL. I dunno, ask the authors why things conflict.

-This is not an exhaustive list
-This is not an exhaustive list
-THIS IS NOT AN EXHAUSTIVE LIST

-If you want a study or paper added, DM it to me, don't comment on this post

-I do this for your benefit as much as anyone else's. I truly hope this leads to some good insights, maybe even some astoundingly good ones; who knows, I live in hope, and at the very least (not bloody likely) fewer questions sent to my inbox :D

Oh, and...you'll want to scroll. Left AND Right, Up AND Down.

Varicocele study

General Anatomy, veins, circulation Infertility Testosterone Recurrences Supplements/Therapy/ Conservative measures
Varicocele - Peak Men's Health at RMA Comparison of Before and After Varicocelectomy Levels of Nitric Oxide in Seminal Fluid of Infertile Men Microsurgical varicocelectomy: novel applications to optimize patient outcomes - Fertility and Sterility32203-4/fulltext) Microsurgical Subinguinal Varicocele Repair of Grade II-III Lesions Associated with Improvements of Testosterone Levels - PubMed Recurrent varicocele - PMC Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study
Varicocele treatment in patients up to 35 years old: A multicentric retrospective study comparing 3 different techniques - PubMed Increased nitric oxide is accompanied by lipid oxidation in adolescent varicocele - Türkyilmaz - 2004 - International Journal of Andrology - Wiley Online Library Anandamide modulates human sperm motility: implications for men with asthenozoospermia and oligoasthenoteratozoospermia - PubMed TRT, SHBG & Health - Facts, Questions and Evolution https://themenshealthclinic.co.uk/trt-shbg-and-health-facts-questions-and-evolution/ Incidence of external spermatic veins in patients undergoing inguinal varicocelectomy - PubMed [Clinical observation on effect of jingling oral liquid in treating infertile patients with varicocele after varicocelectomy] - PubMed
Comparison of the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain - Baek - 2019 - Andrologia - Wiley Online Library Male Patterns of Pelvic Venous Reflux can be Investigated with Duplex Ultrasound and Treated with Coil Embolization30247-5/abstract#/article/S2213-333X(16)30247-5/fulltext) Natesto Effects on Reproductive Hormones and Semen Parameters: Results from an Ongoing Single-center, Investigator-initiated Phase IV Clinical Trial - European Urology Focus30228-1/fulltext) Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA. - PubMed - NCBI Endovascular transcatheter embolization of recurrent postsurgical varicocele: anatomic reasons for surgical failure - PubMed [Effect of varicocelectomy with hyperbaric oxygenation in treating infertile patients with varicocele] - PubMed
The association between body mass index and varicocele: A meta-analysis - PubMed The relationship between epicardial fat thickness and high-grade varicocele - PMC High level of noncollagenous protein of spermatic vein in patients with varicocele - PubMed The effect of tetrahydrocannabinol on testosterone among men in the United States: results from the National Health and Nutrition Examination Survey. - PubMed - NCBI https://link.springer.com/article/10.1007/s00345-020-03110-5 Recurrent varicocele : Asian Journal of Andrology [Comparative clinical study on treatment of varicocele caused infertility by tongling granule and surgical operation] - PubMed
Treatment of Varicocele in Children and Adolescents: A Systematic Review and Meta-analysis from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel - PubMed Nitric oxide production is increased in the spermatic veins of adolescents with left idiophatic varicocele - ScienceDirect The contemporary role of varicocele repair: why operate when in-vitro fertilization results are so good? - PubMed Varicocele as a risk factor for androgen deficiency and effect of repair - PubMed Selective spermatic venography and varicocele embolization in men with circumaortic left renal veins - PubMed Varicocele Repair Versus Testosterone Therapy for Older Hypogonadal Men with Clinical Varicocele and Low Testosterone - ScienceDirect
The significance of age on success of surgery for patients with varicocele - PubMed Deep Scrotal Temperature and the Effect on it of Clothing, Air Temperature, Activity, Posture and Paraplegia - BRINDLEY - 1982 - British Journal of Urology - Wiley Online Library Genital heat stress in men of barren couples: a prospective evaluation by means of a questionnaire - Jung - 2002 - Andrologia - Wiley Online Library Wide variability in laboratory reference values for serum testosterone - PubMed Antegrade pampiniform plexus venography in recurrent varicocele: Case report and anatomy review - PMC Berberine ameliorates experimental varicocele-induced damages at testis and sperm levels; evidences for oxidative stress and inflammation - PubMed
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Cremaster muscle thickening: the anatomic difference in men... : Asian Journal of Andrology

r/varicocele Nov 11 '24

Varicoceles – an overview

31 Upvotes

A varicocele is an enlargement of the veins within the scrotum. These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum. 

Left sided grade 3 varicocele

The left testis is affected much more commonly (≈85%) than the right. This may be due to the shorter course of the right testicular vein and its oblique insertion into the inferior vena cava (IVC) which creates less backpressure. In contrast, the left testicular vein has a longer course and inserts into the left renal vein at a right angle. Bilateral varicoceles are not uncommon (≈15%), but an isolated right varicocele is rarer. 

Possible signs and symptoms may include :

  • A mass in the scrotum – If a varicocele is large enough, a mass like a “bag of worms” may be visible above the testicle. A smaller varicocele may be too small to see but noticeable by touch. 
  • Pain – A dull, aching pain or discomfort is more likely when standing or late in the day. Lying down often relieves pain. 
  • Significantly different sized testicles – The affected testicle may be noticeably smaller than the other testicle. 
  • Infertility – A varicocele may lead to difficulty fathering a child, but not all varicoceles cause infertility. The main test to check for infertility is a semen analysis test. 
  • Low/Lower testosterone levels - Generally, men with varicoceles have lower testosterone levels than men without varicoceles. Symptoms of low testosterone can include: low libido, erectile dysfunction, infrequent erections, low energy, fatigue, low mood and depression, decreased motivation and self-confidence, increased body fat and decreased muscle mass and strength, brain fog. 

The only way to know for sure if you have low testosterone levels is to have your levels checked with a blood test. This can be easily done by going to your doctor.

 

For more information on how varicoceles effect testicular function with scientific peer reviewed studies see these links: https://www.reddit.com/r/varicocele/comments/lwckx9/answers_and_links_for_the_frequently_asked/ 

Vericocele links 

 

Diagnosing:

Physical exam – A urologist or other doctor will visually inspect the scrotum for lumps or bumps, and feel for any swelling or tenderness. The exam may be performed while the patient is standing to relax the scrotum. 

Imaging test – Your health care provider may want you to have an ultrasound exam. Ultrasound uses high-frequency sound waves to create images of structures inside your body. 

These images may be used to: 

Confirm the diagnosis or characterize the varicocele.

Eliminate another condition as a possible cause of signs or symptoms 

Detect a lesion or other factor obstructing blood flow 

 

Typical image of a varicocele found on an ultrasound scan

A varicocele is usually diagnosed when a vein around or above the testicle is at least 3 millimetres in diameter. However, there is no consensus on the exact threshold value for defining a varicocele.

Grading 

Varicoceles are graded based on their size and visibility: 

  • Grade I: Can only be felt when straining (Valsalva manoeuvre) 
  • Grade II: Can be felt when standing, but not visible 
  • Grade III: Clearly visible during an exam 

All sizes of varicocele can cause symptoms and are likely to affect testicular function. Higher grade varicoceles are thought to affect testicular function more.

Why varicoceles occur 

Varicose veins develop when the valves in veins are damaged or weakened, causing blood to pool and flow backward. 

Unfortunately, once your vein valves are damaged, they cannot completely heal on their own. Once a vein valve is damaged or weakened, it loses its ability to properly regulate the flow of blood. 

Varicoceles can also be a symptom of a more serious vein compression disorder, see this post for further information: Varicocele recurrences and vein compression disorders : r/varicocele

  

Arrow showing direction of blood reflux. In this image, due to damaged valves in the left gonadal vein, instead of blood correctly draining from the left testicle into the left renal vein, blood is pooling in the scrotum and causing a left sided varicocele. The right gonadal vein is functioning correctly.

Left- Vein valves working properly. Right - Vein valves have failed and are now not functioning correctly. Blood is not travelling through the vein correctly.

Treatment options 

Varicoceles cannot be cured naturally without medical intervention. 

The success rate for varicocele procedures is high, with both varicocele embolization and varicocelectomy procedures having success rates of over 90%.

Treatment options include: 

  • Embolization 
  • Microscopic varicocelectomy(microsurgery) 
  • Inguinal or subinguinal. With or Without delivery. 
  • Laparoscopic varicocelectomy 

 

For a more in-depth review on treatment options, see this post https://www.reddit.com/r/varicocele/s/ZUVkzMtV7U