Varicocele is a benign and harmless condition that occurs in 10–15% of all men of all ages. The definition is enlarged veins around the testicles due to the blood having difficulty being transported back to the heart. This in turn is due to leakage in the valves inside the veins that connect the testicles to the heart. It is significantly more common on the left side due to different vascular anatomy (80–90% of cases), but can also occur on the right or both sides.

If you have no symptoms, you do not need to treat the varicocele. However, in about half of the cases, the increased pressure in the veins gives rise to symptoms (see below) and then surgery can be considered. Varicocele can also raise the temperature around the testicle, but in most cases does not affect sperm function or the ability to have children.

Common symptoms of varicocele

Symptoms can occur at any age, but usually debut during puberty and can come on insidiously. In most cases, symptoms may come and go, but often worsen slowly over time.

Just like varicose veins elsewhere in the body, the symptoms are usually most noticeable when standing upright (increased pressure) and decrease when lying down (decreased pressure). Heat, exercise and sexual activity can also worsen the symptoms.

The most common symptoms are:

• Feeling of heaviness
• Tenderness
• Molar pain
• Swelling
• Feeling of warmth

If you have symptoms as above that negatively affect your quality of life, you may consider surgery. In rare cases, you may also consider surgery on an asymptomatic patient where an investigation due to infertility has shown a varicocele and reduced sperm quality.

In order to assess a suspected varicocele, we need to know how your symptoms affect you, whether there are other illnesses or lifestyle factors to take into account.

Preparations

Before your appointment at Peritus Clinic, you will:

Fill out a questionnaire regarding your health and lifestyle, your current and previous symptoms, illnesses, treatments, any surgeries, medications and allergies.

If you and your partner have involuntary infertility, you are welcome to bring medical records from any investigation by another unit (we at Peritus Clinic do not perform our own infertility investigations).

Feel free to bring your partner with you if you wish.

Appointment

During your appointment, you will talk to a urologist to tell you more about your symptoms and go through your answers to the questionnaires.

The urologist will then perform a general external physical examination and a targeted examination of the penis and external genitalia with ultrasound. We will also assess whether there are other explanations for your symptoms, such as inguinal hernia or muscle attachment inflammation.

Finally, you will discuss which surgical treatment is best suited for your varicocele and how the treatment should be followed up. Usually, one visit is enough to make a treatment decision.

At Peritus Clinic, we have highly specialized staff and experienced surgeons. Together with you, we assess which possible treatment works best in your case and we always look at the patient’s needs from a holistic perspective.

Treatment of varicocele is surgical and there are a handful of different techniques with different advantages and disadvantages. For more than 20 years, we have been using a well-known method (sclerosis according to Tauber) that has been used since the early 1990s with good results.

The treatment is a minor operation under local anesthesia and you are awake during the procedure. A drug is injected under surgical control into the scrotal hernia and the procedure takes about 20 minutes to perform. You go home within half an hour after the operation is completed. The drug then needs 6–8 weeks to take effect and the final result is not seen until 3–6 months.

Follow-up takes place after three months and the goal of the surgery is to reduce your symptoms and improve your quality of life. The risk of relapse is approximately 3-5%.