A varicocele is caused by dilated veins around the testicle. This is similar to varicose veins in the legs and a varicocele can cause testicular discomfort, especially with standing or straining. Varicoceles can also lead to infertility as it can alter the temperature of the testicle and inhibit normal sperm production.
Many varicoceles are small and are asymptomatic or cause very minimal pain. Larger varicoceles can be palpated around the testicle and have a characteristic “bag of worms” feel.
Large, symptomatic varicoceles can be surgically repaired by clipping the dilated veins through a small groin incision. Alternatively, the large vein draining the testicle can be embolized by an interventional radiologist. Even after treatment, varicoceles may recur but this is relatively uncommon.