A varicocele is an enlargement of the veins within the loose bag of skin that holds your testicles (scrotum). With time, varicoceles might enlarge and become more noticeable. The condition might cause a swollen testicle, almost always on the left side. Varicoceles are a common cause of low sperm production and decreased sperm quality, which can cause infertility.
 
Causes
Veins contain one-way valves that push blood in one direction, toward larger veins. When valves inside the veins in the testicles and scrotum don’t work properly, blood backs up and causes these veins to swell. A varicocele is the result.
 
Diagnosis of Varicocele

• Self-examination of the scrotum, above the testicles, can reveal a mass that feels like a bag of worms. Some patients may experience swelling or tenderness in the area, or a feeling of pressure in the groin when standing for long periods.
• The doctor may detect varicoceles as part of a visit for a general health screening or fertility issues.
  • Physical examination or ultrasound examination of the scrotum if it appears larger than normal, revealing veins that are larger than 2 millimeters in diameter.
  • Enlarged veins along with abnormalities of the sperm, such as low motility (less than 60%), low sperm count, or abnormal sperm shape.
  • Enlarged veins and abnormally small testicles in children.

• To reduce pain in the scrotum
• To treat infertility
• To restore proper blood flow to the reproductive organs

1. A varicocelectomy may be done on an outpatient basis, which means no hospital stay is required.
2. You will undergo a health screening as well as blood tests to measure amount of red blood cells, coagulation, and kidney function.
3. You will need to avoid food and water for 8 hours before the procedure, or as recommended by the doctor.

The procedure is performed using general anesthesia. The doctor will make a diagonal incision above the pubis towards the crease at the groin and treat the blood vessel at the testicle by tying off and cutting the problematic vein. At the same time the doctor will preserve other blood vessels in the testicle. The wound will then be closed and covered with a bandage.
 

After the procedure you will be moved into a recovery area for observation. You will be asked to lie down on your back for 1 hour. Once anesthesia has worn off and you are not experiencing any complications or ill effects from the surgery, you will be allowed to go home. Pain and discomfort can be managed with medication. You may also be prescribed antibiotics to prevent infection. It may take days or weeks for you to feel completely recovered.
 

• Reaction to anesthesia.
• Bleeding at surgical site.
• Infection at surgical site.
• Testicular artery injury
• Formation of hydrocele.
• Damage to nearby nerves, blood vessels, or organs.

• If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
• Travelers to Thailand should plan to stay in the country for at least 2-5 days or for the entire duration of treatment.
• If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel.
• During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
 
What if the procedure is not performed?
While in many cases varicoceles may not cause any problems, if the condition is severe enough to cause pain that interferes with daily life or is the cause of infertility, choosing not to treat it means these issues will not be resolved. Please talk to your doctor about your specific condition and the options for treatment.
 

• In the case of small varicocele, the doctor may recommend wearing a supportive underwear to improve testicular blood circulation.
• Laparoscopic surgery.
• Percutaneous embolization.