Varicocele: what it is, symptoms, causes and treatment 2026

The scrotum consists of a skin-covered sac, inside which we find the testicles. It also contains a series of veins and arteries that are responsible for carrying blood to the different reproductive glands. However, when there is an anomaly in the veins of the scrotum, it can cause the appearance of an annoying and uncomfortable varicocele.

This is a very common condition. In fact, it is estimated that it affects 20 percent of adolescent males, and about 15 percent of the adult male population. However, it tends to be more common in men between 15 and 25 years old. In addition, they usually form during puberty.

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What is varicocele?

A varicocele consists of an enlarged vein in the scrotum and testicle. It is usually found on the left side, although it may also be found on both sides of the scrotum. However, it very rarely occurs only on the right side. They can also exist on both sides, but this is extremely rare.

That is, a varicocele is an enlargement of the veins inside the scrotum, which are called the pampiniform plexus. It is quite similar to varicose veins that can occur in the legs.

And, according to studies, the presence of a varicocele can affect a man's fertility, by reducing the production and quality of sperm, although not all varicoceles affect sperm production, so they do not always have to be related to cases of infertility.

What are its causes?

Experts are not entirely sure what the exact cause is that causes the formation or development of a varicocele. Yes, it is true, as we have told you, that they can appear for the first time during puberty.

A spermatic cord helps support each testicle, which contains veins, arteries and nerves. When the veins inside the scrotum are healthy, one-way valves help move blood from the testicles to the scrotum, and then send it back to the heart.

However, sometimes the blood does not move through the veins as it should, starting to accumulate, which causes it to enlarge. In this way, over time the varicocele will begin to develop, slowly.

There are no established risk factors related to the development of varicocele, although some experts agree that being overweight could increase the risk.

The main symptoms of varicocele

Most men are not aware that they have a varicocele until some related symptoms arise, or if they are asymptomatic, until they begin to experience fertility problems.

Dull, recurrent pain, which is felt in the scrotum, is usually one of the most obvious symptoms, in addition to the appearance of a lump in one of the testicles and swelling in the scrotum. Due to this, it can be seen that one testicle is noticeably smaller than the other.

On the other hand, the feeling of heaviness also tends to be common, especially after having practiced physical exercise.

Varicocele treatment

If the varicocele is asymptomatic, it is common that it is not treated, unless it causes related problems, such as infertility, pain, testicular atrophy. However, since it can cause problems with testicular function in some men, it is known that the sooner it is treated, the greater the chance that sperm production will improve.

This is because the treatment does not produce results quickly, which has to do with the life cycle of semen. That is, at least three to four months must pass after the repair for semen health to show improvement. The doctor may then advise performing a follow-up semen test every three or four months, to check if the treatment was truly successful.

One of the medical treatments of choice is lavaricocelectomy, a surgery that is carried out on the same day, and in which the specialist repairs the affected veins, ligating and sectioning the abnormally dilated testicular veins.

Why can varicocele influence fertility?

Although not all varicoceles negatively influence a man's fertility, it has been found that their presence can cause a reduced sperm count, poor morphology, worse movement and an increase in DNA-damaged sperm.

However, it is not entirely clear why varicoceles cause these problems. One of the most popular theories states that accumulated blood raises the general temperature in both the scrotum and the testicles.

And, as we know, a higher than normal temperature does not go very well with male fertility. And the increase in scrotal heat can be truly harmful to sperm.

But it is not the only theory. Another points out that poor blood circulation leads to the accumulation of higher levels of toxins, which in turn ends up causing poor semen health. While it is also believed that increased pressure on the scrotum damages its health.