Most varicoceles are asymptomatic; however, they may cause pain that varies from mild discomfort to a severe sharp pain. It is a dull, congestive, tooth-ache like pain and is not associated with urination problems or erectile dysfunction. Pain increases with standing and physical exertion over long periods of time and worsens over the course of a day. The pain is usually relieved by lying down.

When it enlarges, the varicocele can cause a clumpy “bag of worms” feel in the scrotum. Typically, painful varicoceles are prominent in size. A decreased sperm count, decreased motility of sperm and increase in the temperature due to varicoceles usually result in infertility in men. Testicular atrophy may also be seen in young boys at puberty.

• Asymptomatic

  Serial SAs are thus recommended in asymptomatic adolescent males with varicoceles and normal testicular development, but the natural history of semen parameters is unknown. [ncbi.nlm.nih.gov]

  Thought to be the result of venous pressure, varicoceles are typically asymptomatic but may present with scrotal discomfort and heaviness. Classically, varicoceles are described as a "bag of worms" on palpation. [visualdx.com]

  Mild varicoceles are commonly asymptomatic, but a dragging scrotal sensation may be felt. [healthcentral.com]

  Most varicoceles are asymptomatic; however, they may cause pain that varies from mild discomfort to a severe sharp pain. It is a dull, congestive, tooth-ache like pain and is not associated with urination problems or erectile dysfunction. [symptoma.com]

• Fever

  Differential Diagnosis of testicular mass: Must-not-miss: Testicular torsion (usually acute, assoc. with pain) Epididymitis (assoc with urethral discharge, erythema, and fever) Acute Orchitis (testicular pain, nausea and vomiting, 3-4 days after mumps [pedclerk.bsd.uchicago.edu]

  However, it is usually milder with fewer blisters and little or no fever. [cdc.gov]

  Other symptoms include Fever Headache Tiredness Loss of appetite Chickenpox is usually mild and lasts 5 to 10 days. Calamine lotions and oatmeal baths can help with itching. Acetaminophen can treat the fever. [medlineplus.gov]

  It starts with the appearance of a characteristic papular exanthema and symptoms including mild fever, malaise, nausea, and headache. Varicella usually has a benign course. [hindawi.com]

  Chickenpox is a highly contagious viral infection that causes an acute fever and blistered rash, mainly in children. The name may be derived from the French term for chickpea, chiche pois. [dermnetnz.org]

• Inflammation

  In all forms of varicose veins, the walls of the veins become hardened, and a certain amount of inflammation develops through the years. [britannica.com]

  KEYWORDS: IL-18; IL-37; inflammation; male infertility; varicocele [ncbi.nlm.nih.gov]

  Stop sitting so much, be active - inactivity and sitting on a chair or sofa all day contribute not only to obesity, but also to increased oxidative damage, and bodily inflammation. [anabolicmen.com]

  Scrotal lumps and inflammation (reviewed Aug 2018). https://www.andrologyaustralia.org/testes-problems/scrotal-lumps-and-inflammation/ (accessed Aug 2018). 2. Mayo Clinic. [mydr.com.au]

• Disability

  Please enable JS and disable any ad blocker [lequotidiendumedecin.fr]

  When a patient has such a medical condition, it can be very disabling – both from a work and social point of view. It is important to get sound medical advice on how to deal with the problem. [irishtimes.com]

  Congenital varicella syndrome can leave the baby with severe, lifetime physical and learning disabilities. Untreated pneumonia caused by varicella in pregnant women can result in severe respiratory disease. [ecdc.europa.eu]

  Women exposed during pregnancy may bear children with birth defects, including: poor growth small head size eye problems intellectual disabilities Most people diagnosed with chickenpox will be advised to manage their symptoms while they wait for the virus [healthline.com]

  It can result in spontaneous abortion, fetal chorioretinitis, cataracts, limb atrophy, cerebral cortical atrophy and microcephaly, cutaneous scars, and neurological disability. Mortality in newborns infected with varicella is up to 30%. [dermnetnz.org]

• Malaise

  The first symptoms of clinical varicella generally appear after a 10-21 day incubation period and include fever, malaise and the characteristic itchy rash. [who.int]

  These include fever, malaise, headache, loss of appetite and abdominal pain. Chickenpox is usually more severe in adults and can be life-threatening in complicated cases. The blisters clear up within one to three weeks but may leave a few scars. [dermnetnz.org]

  Other signs and symptoms, which may appear one to two days before the rash, include: Fever Loss of appetite Headache Tiredness and a general feeling of being unwell (malaise) Once the chickenpox rash appears, it goes through three phases: Raised pink [mayoclinic.org]

  It starts with the appearance of a characteristic papular exanthema and symptoms including mild fever, malaise, nausea, and headache. Varicella usually has a benign course. [hindawi.com]

  Before the rash appears, there will be: a general feeling of being unwell (malaise) fever, which is usually worse in adults than children aching muscles loss of appetite in some cases, a feeling of nausea After the rash appears, there will be: Rash: Severity [medicalnewstoday.com]

• Vomiting

  Differential Diagnosis of testicular mass: Must-not-miss: Testicular torsion (usually acute, assoc. with pain) Epididymitis (assoc with urethral discharge, erythema, and fever) Acute Orchitis (testicular pain, nausea and vomiting, 3-4 days after mumps [pedclerk.bsd.uchicago.edu]

  It can also result from: Chronic coughing, severe or chronic vomiting Diabetes or other diseases Heavy lifting Injury or obesity Pregnancy Prior surgery Ventral Hernia Diagnosis To identify a ventral hernia, a health care provider may use multiple diagnostic [hopkinsmedicine.org]

  If you’re struggling with the many possible symptoms of ventral hernias—from sharp pain to vomiting—you understand the importance of finding prompt, effective treatment. [mountsinai.org]

  Symptoms of strangulation include severe pain, nausea, sweating, vomiting, a rapid heartbeat, and a high fever. Strangulation is an emergency situation requiring immediate surgery. [study.com]

• Nausea

  Differential Diagnosis of testicular mass: Must-not-miss: Testicular torsion (usually acute, assoc. with pain) Epididymitis (assoc with urethral discharge, erythema, and fever) Acute Orchitis (testicular pain, nausea and vomiting, 3-4 days after mumps [pedclerk.bsd.uchicago.edu]

  Minor complications such as bruising at the catheter site, nausea or backache may occur, but are uncommon. Infection, hydrocele or loss of a testicle have not been reported after coil embolization. [nyfertility.org]

  Symptoms of strangulation include severe pain, nausea, sweating, vomiting, a rapid heartbeat, and a high fever. Strangulation is an emergency situation requiring immediate surgery. [study.com]

  Minor complications such as bruising at the entry site, mild backache, or nausea (rare) may occur. [pennmedicine.org]

  If accompanied by nausea or vomiting, an antiemetic such as metoclopramide (Reglan) can be given orally or rectally. [en.wikipedia.org]

• Constipation

  Liquids may prevent constipation and straining during a bowel movement. Ask how much liquid to drink each day and which liquids are best for you. Eat foods high in fiber. Fiber may prevent constipation and straining during a bowel movement. [drugs.com]

  The provider will inquire about and/or look for: Constipation, "narrow" or "thin" stool Lump or protrusion in the abdomen; you may be asked to stand and cough, which increases abdominal pressure and makes the hernia more pronounced and easier to diagnose [hopkinsmedicine.org]

  A ventral hernia’s symptoms are determined by its location in the abdomen and can include sharp pain that may be present during physical activity, vomiting (in the case of incisional hernias), and constipation. [mountsinai.org]

  If the tissue or intestine bulging through the abdominal wall pushes too far out or gets stuck, you will experience some more uncomfortable symptoms like pain, vomiting, nausea, and constipation. [study.com]

  Symptoms of a strangulated hernia include: Continuous, severe pain Redness Nausea and vomiting High fever Increased sweating Constipation A strangulated hernia is a medical emergency and requires immediate surgery. [winchesterhospital.org]

• Abdominal Mass

   2.SECONDARY- pelvic or abdominal mass. - L renal cell carcinoma with tumor thrombus in left vein. -Nutcracker syndrome- SMA compressing left vein. Common conditions- RCC, Retroperitoneal fibrosis or adhesions. 7. [slideshare.net]

• Fissured Tongue

  Ankyloglossia Black hairy tongue Caviar tongue Crenated tongue Cunnilingus tongue Fissured tongue Foliate papillitis Glossitis Geographic tongue Median rhomboid glossitis Transient lingual papillitis Glossoptosis Hypoglossia Lingual thyroid Macroglossia [en.wikipedia.org]

• Thrombosis

  Spontaneous thrombosis of varicocele is a rare cause of acute scrotal pain. Pain out of proportion to clinical features is characteristic. Patients not responding to medical therapy may need varicocelectomy. [ncbi.nlm.nih.gov]

  These include : artery damage further testicular atrophy infection bruising, swelling, or a buildup of fluids in the area abdominal pain Rarely, a renal vein thrombosis may develop. This can affect the kidney and may need further surgery. [medicalnewstoday.com]

  Risk factors for varicocele development would be poor outflow of the venous system such as those found in nutcracker syndrome or extensive deep vein thrombosis. [floridasurgicalclinic.com]

  Other complications included deep vein thrombosis (0.5%), pneumonia (1%), cardiac events (0.5%), and problems requiring reoperation (4.2%). At 2-year follow-up, 1.5% of the study participants had died and 5.1% had ventral hernia recurrences. [mdedge.com]

• Vein Disorder

  A varicose vein disorder can be a cause of male infertility but is fortunately, also the most surgically correctable. [malefertility.md]

• Foot Ulcer

  Both blisters and calluses can lead to more serious complications, such as foot ulceration and infection, particularly when sensation or circulation is impaired, as in the case of diabetes, neuropathy or peripheral artery disease (PAD). [en.wikipedia.org]

• Fracture

  […] eruption Neonatal teeth Pulp calcification Pulp stone Pulp canal obliteration Pulp necrosis Pulp polyp Pulpitis Regional odontodysplasia Resorption Shovel-shaped incisors Supernumerary root Taurodontism Trauma Avulsion Cracked tooth syndrome Vertical root fracture [en.wikipedia.org]

• Confusion

  We would also like to highlight the differentiating points between spontaneous thrombosis and post operative in vitro clot formation in the varicoceles, as these two entities can often be confused for each other. [ncbi.nlm.nih.gov]

  Varicoceles are sometimes confused with the most common scrotal mass, the hydrocele - an over-accumulation of the fluid that is normally found between the two layers of membrane that envelop the testicle. [healthcentral.com]

  Anorexia is not to be confused with the mental health diagnosis, anorexia nervosa. Because the terms are commonly used interchangeably, a provider must clarify to a patient to which they are referring as to avoid confusion. [en.wikipedia.org]

  On rare occasions, chickenpox may be confused with scabies or some types of insect bites. [medicalnewstoday.com]

• Lethargy

  Features of renal cell carcinoma such as painless haematuria, loss of weight, loss of appetite, easy fatigability and lethargy The left testicular vein drains first into the left renal vein and then to inferior vena cava (IVC) while right testicular vein [medicaljoyworks.com]

• Swelling of the Scrotum

  However, you might experience: a lump in one of your testicles swelling in your scrotum visibly enlarged or twisted veins in your scrotum, which are often described as looking like a bag of worms a dull, recurring pain in your scrotum This condition can [healthline.com]

  Varicoceles are a widening and swelling of veins in the scrotum that are similar to varicose veins in the legs or hemorrhoids. [sharecare.com]

  Alerts and Notices Synopsis   A varicocele is a usually painless swelling of the scrotum involving dilated spermatic veins (pampiniform plexus) that form a soft scrotal mass, most often on the left side. [visualdx.com]

  The swelling of the veins can also be palpable—one can feel the swelling and twisting of the veins in the scrotum. At times, varicoceles can cause pain within the scrotum or heaviness in the testicles. [docdoc.com.sg]

• Scrotal Mass

  ‘Other benign conditions resulting in a scrotal mass, such as testicular torsion, spermatocele, varicocele, or tuberculosis, must be ruled out.’ ‘Scrotal ultrasonography is helpful in confirming a varicocele or testicular tumour.’ [en.oxforddictionaries.com]

  Painless scrotal mass. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/painless-scrotal-mass. Updated March 2017. Accessed March 8, 2018. [winchesterhospital.org]

  Alerts and Notices Synopsis   A varicocele is a usually painless swelling of the scrotum involving dilated spermatic veins (pampiniform plexus) that form a soft scrotal mass, most often on the left side. [visualdx.com]

  Varicoceles are sometimes confused with the most common scrotal mass, the hydrocele - an over-accumulation of the fluid that is normally found between the two layers of membrane that envelop the testicle. [healthcentral.com]

• Sexual Dysfunction

  KEYWORDS: intracytoplasmic sperm injection; microsurgical varicocelectomy; nonobstructive azoospermia; sexual dysfunction; varicocele [ncbi.nlm.nih.gov]

  Langille, The Impact of the Environment on Sexual Health, Management of Sexual Dysfunction in Men and Women, 10.1007/978-1-4939-3100-2_3, (17-24), (2016). [dx.doi.org]

• Testicular Swelling

  We describe the sonographic and colour Doppler appearances of this poorly described entity in a middle-aged man referred for evaluation of a painful left testicular swelling. [ncbi.nlm.nih.gov]

The gold standard way to diagnose varicocele is by physical examination. About 95 percent of varicoceles are found on the left side of the scrotum. The general physical examination of a patient in standing position reveal a tender, non twisted mass above the testicle.

If large enough, it can be felt as a bag of worms. If a varicocele is small, it can be felt by asking the patient to take a deep breath and hold it (Valsalva maneuver). The testicles may be shrunken in size.

During palpation, a varicocele must be differentiated from the lipoma of the cord. Unlike a varicocele, a lipoma will not go away when the patient lies down.

A noninvasive imaging exam called color flow ultrasound or a venogram can often be used to detect a varicocele, if not diagnosed through the physical examination.

• Sperm Count Decreased

  A decreased sperm count, decreased motility of sperm and increase in the temperature due to varicoceles usually result in infertility in men. Testicular atrophy may also be seen in young boys at puberty. [symptoma.com]

  Decreased sperm count, decreased motility of sperm, and an increase in the number of deformed sperm are related to varicoceles. [radiology.ucsf.edu]

  Fertility problems including decreased sperm count, decreased motility and an increase in the number of deformed sperm. Atrophy (shrinking) of the affected testicle. How is varicocele diagnosed? The gold standard is a physical examination. [drshrid.com]

  Other signs of varicoceles can be a decreased sperm count; decreased motility, or movement, of sperm; and an increase in the number of deformed sperm. [indianinterventionalradiology.com]

  The detrimental effect of varicocele on spermatogenesis in the subfertile male is manifested by low sperm count, decreased sperm motility and low percentage of normal sperm morphology together or in different combinations. [stonybrookmedicine.edu]

Varicocele treatment may not be necessary until it causes pain, testicular atrophy or infertility in men. There are both surgical and non-surgical options available to treat a varicocele. The purpose of treatment is to seal off affected veins to redirect the blood flow into normal veins.

• Varicocele embolization: A catheter directed varicocele embolization is a nonsurgical treatment that is highly effective to treat symptomatic varicoceles [5] [6]. A thin catheter is passed directly to the testicular vein at the groin under local anesthesia. The abnormal veins can be blocked by using coils or sclerosants under direct visualization of the veins. By embolizing the vein, blood flow is redirected to normal veins through alternate pathways.
• Varicocelectomy: The most common surgical procedure to treat varicocele is surgical ligation which is known as varicocelectomy [7]. The most common approaches are inguinal, retroperitoneal and subinguinal [8]. A specially designed surgical instrument can be used to cut the veins by making two small incisions in the groin under general anesthesia. Patients of open surgical ligation can expect a two to three week recovery period.
• Medical treatment with L-carnitine also has a beneficial effect [9] [10].

Varicoceles may be harmless but in some cases they can cause infertility and pain. About 2% to 5% of patients develop a condition called hydrocele. There are studies showing improvement in sperm quality in 57% of the cases after varicocelectomy. Recurrences are common and occur in 5% to 20% of the cases.

Varicoceles usually develop in men older than 40 years of age due to blockage of large veins higher in abdomen. The major risk factors associated with varicocele include obesity and tumor masses such as kidney tumor. Both of these conditions cause pressure on the veins which can block blood flow to the veins.

The majority of varicoceles develop in teenagers and young men and are not due to a serious condition. There may also be a genetic cause of varicocele as the condition occurs usually in individuals of the same family.

Varicoceles are a relatively common condition affecting approximately 10 percent of men. These are more common in young men, usually during the second and third decade of life.

About 40 percent cases of infertility in men occur due to varicoceles. Nine out of ten varicoceles develop in the left testicles, although it can be bilateral at the same time. The prevalence of varicocele may be as high as 80%.

A varicocele forms when the valves inside the veins in the spermatic cord do not function properly. In healthy veins within the scrotum, one-way valves allow blood to flow from testicles and scrotum back to the heart. In varicoceles, the poor functioning valves and increased resistance to blood flow result in increased venous pressure. This can cause dilation and tortuosity of the pampiniform plexus, which is a network of veins that drain the testicle.

One of the main functions of the plexus is to lower the temperature of the testicles; varicoceles cause this function to be lost and lead to a higher temperature of the testes causing testicular atrophy. Due to reduction in the supply of oxygenated blood and nutrient material to the sperm production sites, the quality and the quantity of the sperms is affected, causing infertility in men [2].

A secondary varicocele is due to compression of the venous drainage of the testicle [3] [4]. The most common cause is renal cell carcinoma. One non-malignant cause of a secondary varicocele is Nut-cracker syndrome, a condition in which superior mesenteric artery compresses the left renal vein causing increased pressure to be transmitted into the left pampiniform plexus.

A varicocele cannot be prevented from developing; however, the preventive measures that can be helpful include self-monitoring, regular checking of testicles every month knowing what they look and feel like, and look for any change in the shape and size of scrotum.

As high temperatures can trigger a wide veins around the testicles, so being in a room with high temperature continuously must be avoided. Moreover, it is recommended to wear special pants as protector and avoid too much wear jeans or tights. The activities such as unskilled labor, heavy weight lifting must be avoided to prevent varicoceles.

Varicocele is a mass of enlarged and dilated veins within the scrotum [1]. It is a varicose vein of the testicle and scrotum that may cause pain and lead to testicular shrinkage.

The condition is usually characterized by visible veins and feeling of heaviness in the testicle. Varicoceles are a common cause of infertility in men due to poor quality of the sperms that are produced in this disorder.

Varicoceles are observed in 15% of the male population and are generally acquired during puberty. If a varicocele causes symptoms, it can be repaired surgically.

Varicocele is the swelling of veins inside the scrotum. The condition is common in young boys at puberty and men older than 40 years of age. The patients usually present with visible enlarged veins, pain within the scrotum and feeling of heaviness in the testicle. It can be treated by surgical procedure.

1. Agger P. [Scrotal varicocele. A review]. Ugeskrift for laeger. Feb 14 1972;134(7):317-320.
2. Lu YQ, Chen B. [Progress in researches on the mechanism of varicocele-induced male infertility]. Zhonghua nan ke xue = National journal of andrology. May 2008;14(5):454-458.
3. Masuda F, Kudo K, Sasaki T, Onodera S, Machida T. [Varicocele as a symptom in renal cell carcinoma (author's transl)]. Nihon Hinyokika Gakkai zasshi. The japanese journal of urology. Dec 1975;66(12):876-880.
4. Espinosa Bravo R, Lemourt Oliva M, Perez Monzon AF, et al. [Renal cell carcinoma and simultaneous left varicocele]. Archivos espanoles de urologia. Jun 2003;56(5):533-535.
5. Gonzalez R, Narayan P, Castaneda-Zuniga WR, Amplatz K. Transvenous embolization of the internal spermatic veins for the treatment of varicocele scroti. The Urologic clinics of North America. Feb 1982;9(1):177-184.
6. Gonzalez R, Narayan P, Formanek A, Amplatz K. Transvenous embolization of internal spermatic veins: nonoperative approach to treatment of varicocele. Urology. Mar 1981;17(3):246-248.
7. Raheem OA. Surgical management of adolescent varicocele: Systematic review of the world literature. Urology annals. Jul 2013;5(3):133-139.
8. Zini A. Varicocelectomy: microsurgical subinguinal technique is the treatment of choice. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. Sep 2007;1(3):273-276.
9. Cavallini G, Ferraretti AP, Gianaroli L, Biagiotti G, Vitali G. Cinnoxicam and L-carnitine/acetyl-L-carnitine treatment for idiopathic and varicocele-associated oligoasthenospermia. Journal of andrology. Sep-Oct 2004;25(5):761-770; discussion 771-762.
10. Akdemir S, Gurocak S, Konac E, et al. Different surgical techniques and L-carnitine supplementation in an experimental varicocele model. Andrologia. Oct 10 2013.