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.

• 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]

  </p> <p>To control your child's fever, use <a href="/Article?contentid=62&language=English">acetaminophen</a> (said like ah-SEE-tah-MIN-oh-fen.) Your pharmacist can help you choose an anti-fever medicine with acetaminophen. [aboutkidshealth.ca]

• Severe Pain

  He had no relief and continued to have severe pain. Clinical examination was normal. Patient underwent exploratory surgery on a semi- emergent basis. Exploration revealed normal testis with thrombosed varicoceles. Patient underwent Varicocelectomy. [ncbi.nlm.nih.gov]

  As long as your child is comfortable and not having pain, he may return to more strenuous, normal activity, like exercising, after about four weeks. He shouldn’t experience any severe pain. Most people experience only mild pain. [beaumont.org]

  In this situation, the strangulated tissue can quickly develop gangrene, erupt or die - which can lead to severe infections and death. Symptoms of strangulation include severe pain, nausea, sweating, vomiting, a rapid heartbeat, and a high fever. [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]

  Or you could experience discomfort or severe pain in the area of your hernia, which might grow worse when you try to stand or lift heavy objects. You may see or feel a bulging or growth in the area that feels tender to the touch. [healthline.com]

• Lymphedema

  Codes ICD10CM: I86.1 – Scrotal varices SNOMEDCT: 51070004 – Varicocele Look For Subscription Required Diagnostic Pearls Subscription Required Differential Diagnosis & Pitfalls Hydrocele (will transilluminate) Inguinal hernia Epidermoid cyst Lymphedema [visualdx.com]

• Lymphadenopathy

  Additional pathologies would include diastasis recti, abscess, muscle strain, seroma, wound hematoma, lymphadenopathy, soft tissue malignancy, and rectus sheath hematomas. [ncbi.nlm.nih.gov]

• 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]

• Irritability

  […] lotion ATC code D02AB (WHO) Calamine, also known as calamine lotion, is a medication used to treat mild itchiness.[2][3] This includes from sunburn, insect bites, poison ivy, poison oak, or other mild skin conditions.[4][5] It may also help dry out skin irritation [en.wikipedia.org]

  Your physician does this by placing small coils and/or sclerosants (medicine that is injected directly into your veins which irritates the vein and causes them to become occluded). [azuravascularcare.com]

  Try adding oatmeal, baking soda or non-irritating moisturising bath lotion to the bath water. Pat dry, do not rub, after bathing Moisturise with non-irritating skin lotion. Calamine lotion is not recommended as it can dry out the skin. [immune.org.nz]

• Seizure

  There is a very small risk of febrile seizures after vaccination. [kidshealth.org]

  These can include pneumonia, infection of the brain and/or spinal cord covering, or seizures that are often associated with fever. In people with serious immune system problems, this vaccine may cause an infection which may be life-threatening. [cdc.gov]

  Post-ictal headaches: Headaches that happen after a convulsion or other type of seizure, as part of the period after the seizure (the post-ictal state) Gastrointestinal disorders may cause headaches, including Helicobacter pylori infection, celiac disease [en.wikipedia.org]

  The vaccine can be combined with the measles, mumps and rubella vaccine, but for some children between the ages of 12 and 23 months, the combination may increase the risk of fever and seizure from the vaccine. [mayoclinic.org]

  Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics. 2010 Jul. 126(1):e1-8. [Medline]. Hviid A. Measles-mumps-rubella-varicella combination vaccine increases risk of febrile seizure. [emedicine.medscape.com]

• Testicular Pain

  We report a patient who underwent embolization of a varicocele for chronic testicular pain with Gianturco coils and developed increased bilateral pain. Complete pain relief was achieved by laparoscopic resection of both spermatic cords. [ncbi.nlm.nih.gov]

  pain or discomfort; or When there is a significant discrepancy between the size of the two testicles. [malereproduction.com]

  This intervention is only recommended for the treatment of scrotal pain once all other causes of testicular pain have been ruled out, and all conservative measures for pain control have been exhausted. [piedmont.org]

• Scrotal Pain

  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]

  Varicoceles arise during puberty, so varicocele-related scrotal or testicular pain is rarely a new diagnosis in older age men. Similarly, a varicocele is rarely the etiology for acute scrotal pain. [tau.amegroups.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]

  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]

  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]

• 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]

• Testicular Mass

  Varicoceles are nonacute testicular masses caused by dilation of the testicular veins. They typically present with dull, aching unilateral or bilateral scrotal pain. [pedclerk.bsd.uchicago.edu]

  In adolescents diagnosed with varicoceles and accompanying testicular atrophy, studies show that varicocele repair leads, not only to a halting of loss of testicular mass, but also rapid catch-up growth of the affected testicle. [piedmont.org]

  Your doctor may order an ultrasound of the scrotum if the physical exam is inclusive, or if there is a testicular mass that doesn't seem to be a varicocele. [verywellfamily.com]

  […] atrophy.44 This loss in testicular mass is accompanied by dysfunctional testicular tissue, as evidenced by studies that have biopsied testicles with varicoceles.45 46 Orchalgia is present in approximately 2 to 10% of men with varicoceles, and is described [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.