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Varikozele
Varicose veins at the testicle are common — mainly relevant with symptoms or a wish for children.
Also known as: varicocele · scrotal varicose veins
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A varicocele is a widening of the veins in the scrotum — essentially a varicose vein at the testicle, like varicose veins in the leg. It is fairly common, almost always occurs on the left side and is usually harmless. Many men don’t notice it; sometimes it feels like a “bag of worms”, can cause a pulling or heavy feeling that increases after prolonged standing, or is found on examination. In most cases no treatment is needed. The varicocele gains importance mainly in two situations: when it causes symptoms, or when there is a wish to have children, since it can in some cases impair sperm quality. A varicocele that appears suddenly, occurs only on the right, or does not recede when lying down should be medically assessed — then a closer look is taken to be safe.
Without symptoms or fertility wish, often no treatment is needed.
Pulling/heaviness or fertility wish → urological assessment.
There are good procedures to close the widened veins.
Regular self-checks help notice changes (see testicular cancer).
About fifteen in a hundred men have a varicocele, in more than eighty per cent on the left — because of the angle at which the left testicular vein joins. In men being investigated for fertility it is found in about forty in a hundred. After surgery, semen values improve in some over three to six months, because a maturation cycle takes about seventy-four days — values measured before then say little.
There is no drug for a varicocele. Painkillers and supportive underwear take the dragging feeling; they change nothing about the backflow. What removes it is tying off or blocking the vein through a catheter — both with similar results, the catheter route with shorter recovery. Treatment is for pain, for a growing difference in testis size in an adolescent, or for abnormal semen values when trying to conceive — not because it is there.
Widened scrotal veins, almost always on the left, usually harmless.
Many don’t notice it; sometimes pulling/heaviness when standing.
It can in some cases affect sperm quality.
Suddenly new, only on the right or remaining when lying → closer medical check.
More a dragging or heaviness than a pain, more often on the left, stronger when standing and towards evening, better lying down.
A raised value speaks for the formation of sperm suffering. That is the real reason a varicose vein at the testicle is treated at all.
Measured in the morning. With a marked finding it can fall; that belongs known before a procedure.
Supplements the other two and shows whether the control from the brain or the testicle itself is affected.
They lower the blood fats and act on the excitability of the heart muscle. Oily sea fish twice a week is the best-supported route; very high doses from capsules are not a harmless more.
Keeps the rhythm steady and lowers blood pressure. Water tablets drive it down, certain blood pressure drugs and a weak kidney drive it up — which is why it is checked under treatment.
A lack favours extra beats and at the same time keeps a potassium deficiency going. Anyone replacing only the potassium sees no success while the magnesium is missing.
Less salt lowers blood pressure measurably, and most of it is not in the salt cellar but in bread, cheese, cured meat and ready meals. With very low blood pressure the opposite applies.
Studied for vein complaints — 100–200 mg a day over 8 weeks; the studies mostly come from the same supplier. On the widened vein itself nothing swallowed acts.
With impaired sperm quality 200–300 mg a day over 6 months has been studied, with better values for motility and count. Whether more pregnancies follow from that is not shown.
Studied together with folic acid in couples trying to conceive. The largest trial, 5 mg folic acid and 30 mg zinc over 6 months, found no difference in the number of births — a cleanly measured no.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
Sometimes lower with a marked varicocele. It is recognised by palpation and ultrasound, though, not by a value.
Rises when sperm production suffers. On fertility the semen analysis says far more than any blood value.
Small studies with zinc, selenium, folate and vitamin C over 3–6 months found better semen values. The weight of evidence is limited because sperm production renews over 3 months anyway.
Zinc, selenium and folate are studied for semen quality. Small studies over 3–6 months show better values — sperm production renews in about 3 months anyway, which makes judging harder.