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Varicose veins in the testicles are called a varicocele. They develop when veins around the testicle become enlarged, usually because blood does not drain properly. Many varicoceles cause no symptoms, but some men notice a dull ache, heaviness, swelling or a “bag of worms” feeling.
Varicose veins in the testicles are medically known as a varicocele.
A varicocele is an enlargement of the veins within the scrotum. These veins are part of the network that carries blood away from the testicle. When the valves that normally help blood flow upward do not work effectively, blood can pool and enlarge the veins.
Varicoceles are relatively common and often cause no symptoms.
Doctar's varicocele symptoms and treatment guide covers the condition in more detail.
A varicocele may feel like a soft collection of enlarged veins above or around the testicle.
Some men describe the sensation as a “bag of worms,” particularly when standing. The veins may become less noticeable when lying down because gravity reduces blood pooling.
A varicocele may also cause:
a dull ache in the scrotum
heaviness or dragging discomfort
swelling around the testicle
enlarged veins that are visible or easy to feel
a difference in testicle size
fertility difficulties in some men
Not every scrotal lump is a varicocele, however. A new lump should be medically assessed.
Most varicoceles occur on the left side.
This is partly related to differences in the anatomy of the veins draining the left testicle. Right-sided or suddenly appearing varicoceles deserve careful medical assessment because the underlying cause can occasionally be different.
A varicocele can also occur on both sides.
It can, although many men have no pain.
When symptoms occur, the discomfort is often described as a dull, aching or dragging sensation rather than sudden severe pain. It may become more noticeable after prolonged standing, exercise or physical activity and improve when lying down.
Sudden, severe testicular pain is not typical of an uncomplicated varicocele and needs urgent medical evaluation.
Yes, in some men.
The testicles need a temperature slightly below core body temperature for normal sperm production. Enlarged veins may interfere with the testicular cooling system and blood flow, potentially affecting sperm production or quality.
A varicocele does not mean that a man is infertile.
Many men with varicoceles father children without treatment. The significance depends on the size of the varicocele, semen results, testicular development and the couple's fertility situation.
Doctar's male infertility causes guide explains other factors that can affect male fertility.
Some clinically significant varicoceles are associated with reduced sperm production or poorer semen quality.
If fertility is a concern, doctors may recommend a semen analysis rather than assuming the varicocele is responsible.
Doctar's semen analysis guide explains what a semen test can measure.
A doctor may also recommend hormone testing or other fertility investigations depending on the circumstances.
Yes.
A significant varicocele can sometimes be associated with reduced growth or volume of the affected testicle, particularly when it develops during adolescence.
This is one reason doctors may monitor testicular size in younger males with a clinically significant varicocele.
A noticeable difference in testicle size should be evaluated rather than assumed to be caused by a varicocele.
A doctor can often identify a varicocele through a physical examination.
The examination may be performed while standing and lying down. The doctor may also ask the patient to bear down briefly, which can make enlarged veins easier to detect.
If the diagnosis is uncertain, a scrotal ultrasound with Doppler can show the veins and blood flow.
Ultrasound can also help distinguish a varicocele from other causes of scrotal swelling.
No.
Many varicoceles do not need treatment if they cause no symptoms, do not affect testicular development and are not associated with fertility problems.
Treatment may be considered when there is:
persistent pain attributed to the varicocele
abnormal semen parameters in a man trying to conceive
testicular growth or size concerns
a clinically significant varicocele associated with reproductive problems
The decision should be individualised with a urologist.
If the varicocele is small and causes no significant problems, monitoring may be all that is needed.
This can include follow-up examinations and, in selected cases, semen testing or assessment of testicular size.
Varicocelectomy is a procedure that closes or ties off the enlarged veins, redirecting blood through healthier veins.
It can be performed using different surgical approaches, including microsurgical techniques.
The goal is to improve blood drainage and, in selected men, potentially improve fertility or relieve pain.
Embolisation is a minimally invasive procedure performed by an interventional radiologist.
A small catheter is used to block the abnormal veins so blood is redirected through other veins.
The appropriate treatment depends on the individual's anatomy, symptoms, fertility goals and local expertise.
Physical activity does not necessarily cause a varicocele, but prolonged standing or strenuous activity may make discomfort more noticeable in some men.
If exercise consistently causes scrotal pain or swelling, speak with a healthcare professional rather than simply stopping all physical activity.
A supportive garment may sometimes make symptoms more comfortable, but it does not correct the enlarged veins.
A true varicocele generally does not simply disappear.
Symptoms can fluctuate, and the veins may be less prominent when lying down. That can make it seem as though the condition has gone away.
If the veins are becoming increasingly prominent or symptoms are changing, a medical examination is appropriate.
Most varicoceles are not dangerous.
The main concerns are persistent pain, testicular changes and possible effects on sperm production in some men.
A sudden new scrotal swelling, especially on the right side, should be assessed because not every enlarged vein-like swelling is a simple varicocele.
A varicocele and testicular cancer are very different conditions.
A varicocele involves enlarged veins around the testicle. Testicular cancer generally develops within the testicle itself.
A new hard lump inside the testicle should not be dismissed as a varicocele.
Doctar's testicular cancer self-exam guide explains which testicular changes should prompt medical evaluation.
Epididymitis is inflammation of the epididymis, often associated with infection.
It commonly causes pain, tenderness and swelling and may be accompanied by fever, urinary burning or penile discharge.
A varicocele is an abnormal enlargement of veins and usually does not cause fever or penile discharge.
Doctar's epididymitis symptoms guide explains the differences in more detail.
A varicocele is not generally considered a direct cause of erectile dysfunction.
Some research has explored relationships between varicocele, testosterone and sexual function, but an erection problem should not automatically be blamed on enlarged scrotal veins.
Persistent erectile difficulties have many possible causes, including vascular, hormonal, medication-related and psychological factors.
Doctar's erectile dysfunction guide explains common causes.
The testicles produce testosterone as well as sperm, and some studies have found an association between clinically significant varicoceles and lower testosterone levels.
However, this does not mean that every man with a varicocele has low testosterone.
If symptoms suggest low testosterone, a doctor may recommend appropriate blood testing rather than assuming the varicocele is responsible.
Doctar's understanding testosterone levels provides additional information.
In selected men, treating a clinically significant varicocele can improve semen parameters and may improve the chance of pregnancy.
But treatment is not a guaranteed fertility cure.
A fertility specialist or urologist considers the man's semen results, testicular examination, partner's fertility factors and the presence of a clinically significant varicocele before recommending treatment.
Doctar's male fertility testing guide provides a broader overview.
Arrange a medical evaluation if you notice:
enlarged veins around a testicle
persistent scrotal aching
swelling or heaviness
a change in testicle size
difficulty conceiving
a new scrotal lump
a newly developed right-sided varicocele
symptoms that are getting worse
Seek urgent medical care for sudden or severe testicular pain, particularly if there is nausea, vomiting or rapid swelling. Testicular torsion is an emergency and can threaten the testicle if treatment is delayed.
In clinical practice, men often discover a varicocele while checking for fertility problems or a scrotal lump. The important point is not to assume that every enlarged vein is harmless or that every varicocele needs surgery. Examination and, when necessary, ultrasound help separate the two.
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