Expert advice

Dr Caroline West: GP

Dr Caroline West combines her role in a busy inner-city general medical practice with presenting, producing and writing for a number of Australian television shows and magazines. ASK ME A QUESTION

What is a Varicocele

Thursday, July 18, 2002
Some men have described their varicocele as feeling a bit like a "warm bag of worms" in the scrotum.

Can you please tell me what a varicocele is exactly? Is it possible to pick one up on self examination of the testicles? Do they need to have treatment or can they be left alone?

A varicocele is a collection of varicose veins around the testis in the scrotum which may be first picked up by self examination. Some men have described their varicocele as feeling a bit like a "warm bag of worms" in the scrotum. The blood pooled in these varicose veins responds to gravity. So the dilated veins can be seen or felt on standing, but they disappear on lying down. A varicocele is almost exclusively found on the left hand side and is caused by faulty valves in the main testicular vein. In most instances men can be reassured that varicoceles are very common and usually harmless. Once a diagnosis is confirmed, varicoceles can often be left alone. In the past it was thought that the presence of these varicose veins and all the warm blood they carry may raise the temperature around the testis and reduce sperm production and fertility. While this view is now controversial, some doctors recommend that if improving sperm counts and fertility is an issue, or the varicocele is uncomfortable or large, surgery may be an option. If you have any concerns about any scrotal swellings or lumps, it's always wise to check it with your doctor.

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