A varicocele is a condition that occurs when the veins in the scrotum become enlarged and twisted. The scrotum is a pouch of skin that contains the testicles and the blood vessels that supply the reproductive organs.
A varicocele is a condition characterized by the enlargement and twisting of the veins in the scrotum, specifically the pampiniform plexus. The pampiniform plexus is a network of veins that plays a role in cooling the testicles. Similar to varicose veins in the legs, varicoceles can cause the veins in the scrotum to become dilated and abnormal and can result in reduced sperm production and quality, which in some cases can cause infertility. It can also cause shrinkage of the testicles. 
Varicoceles are most common in men between the ages of 15 and 25, and they affect around 15% of all men and 35% of men with primary infertility, mostly in males aged 15-25. They generally develop during puberty, mostly on the left side of the scrotum. They can occur on both sides but it is rare. 

Symptoms of Varicocele

Varicoceles are a condition in which the veins in the scrotum become enlarged and twisted. This can cause several symptoms, which may include:

• Pain or Discomfort: Some men with varicoceles may experience a dull ache or a feeling of heaviness in the scrotum, especially when standing for long periods of time.
• Swelling: The scrotum may appear swollen or larger than normal due to the enlarged veins.
• Shrinking of the testicles: The testicles may appear smaller than normal due to the reduced blood flow caused by the varicocele.
• Infertility: Varicoceles can affect the production and quality of sperm, which can lead to infertility in some men.
• Testicular Atrophy: Varicoceles can cause shrinkage of the testicles, which can lead to testicular atrophy.

It's important to note that not all varicoceles cause symptoms. In some cases, a varicocele may be discovered during a routine physical examination.

Causes of Varicocele

While the exact cause of varicocele is not fully understood, several factors are believed to contribute to its development. Here are some of the common causes:

• Faulty Valves: The primary cause of varicocele is the malfunctioning of valves within the veins that are responsible for regulating blood flow. When these valves fail to function properly, blood can accumulate and pool in the veins, causing them to enlarge and become varicose.
• Abnormal Anatomy: In some cases, individuals may have certain anatomical variations that make them more prone to developing varicocele. These variations can include the presence of additional veins or abnormalities in the structures that support the testicles and scrotum.
• Increased Blood Pressure: Elevated pressure within the blood vessels can contribute to the development of varicocele. Factors that can lead to increased blood pressure in the veins include heavy lifting, straining during bowel movements, and prolonged standing or sitting.
• Genetic Predisposition: There is evidence to suggest that varicocele may have a genetic component. It is believed that certain individuals may inherit a predisposition to weakened vein walls or faulty valves, making them more susceptible to developing varicocele.

While these are some of the common causes associated with varicocele, the condition can also occur without any specific cause or underlying condition. It is advisable to consult with a healthcare professional specializing in urology or reproductive health for a comprehensive evaluation and diagnosis. Understanding the causes of varicocele can help individuals take proactive steps to prevent or manage the condition. 

We understand that varicocele can be a sensitive and challenging condition to deal with, and we strive to provide our patients with the compassion, understanding, and care they need to achieve the best possible outcome if you would like to learn more about varicoceles or to schedule an appointment with one of our Andrologists at MASSH.