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What are the symptoms of varicoceles?

4 fertility expert(s) answered this question

Answer from: Sibte Hassan, MBBS, FCPS, MRCOG, MSc

Gynaecologist, Fertility specialist and Gynaecologist at London Womens Clinic
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Varicocele is actually a dilated vein around the testicular tissue. Every organ is obviously gets a blood supply from the arteries and the blood is drained back through the veins, so if the veins which drain the testes they become dilated, then what happens is that blood stays there for a longer time and it can lead to increased temperature in the local area which is obviously is not good for the spermatogenesis process. The reason behind that is that, the veins contain the well which pushes the blood towards the heart and if the venus the valvular function is disturbed because of many reasons (like prolonged standing, may be overweight or there is some genetic insufficiency of the valves), then the blood is not properly drained and it stays there and it can appear as a dilated vein and the patient can feel it or they can see it. Commonly it is described as a bag of worms like feeling. A patient if they specifically (if they stand for prolonged time) they could feel a dull achy sensation in their scrotal inguinal or scrotal area and this can be further evaluated by a clinical examination by a doctor to categorize the severity of that varicocele, whether it is mild moderate or swear and whether it is on one side or both sides. Commonly it is on the left side because of the anatomy of the left sided vein compared to the right sided vein and then you can also do imaging by doing testicular ultrasound scan, you can know about this presence or the severity of the varicocele and that is the relation with fertility as well that because the blood stays for a longer time it generates heat and sometimes it can have an impact on the number and quality of sperm.

Answer from: Michael Carroll, BSc, PhD, PgCAP, CBiol, FRSB, FIBMS, FHEA, FLS, ANSHCS

Embryologist, Reader (Associate Professor) in Reproductive Science at Manchester Metropolitan University
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It depends on the grade, it depends if it’s clinical or subclinical. The symptoms normally they’re non-painful swelling, dilated veins within the scrotum and you can see it like a bag of worms if you like in severe cases. So, because it doesn’t offer any painful or uncomfortable feelings usually, it can be often ignored but if an individual sees they have obvious varicocele here they should be checked by the doctor and then have a semen analysis to make sure that nothing is gone that way. Symptoms wise, it’s usually very mild if anything at all. It’s really due to the visual effect that demonstrates the degree of varicocele.

Answer from: Sheena Lewis, Professor of Reproductive Medicine

Andrologist, CEO Examen, Executive committee ARCS
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Because veins around the testes are then that increases the temperature and that can decrease the quality of their sperm and decrease their chances of becoming a dad. Urologists or andrologists are the men who can check out whether men have got (well they’re not all men but they usually men there are women who are urologists as well that was a sexist thing to say), those are the doctors who can check men and see if they have varicose veins and those can be repaired as an outpatient procedure and then a man’s sperm quality can improve within six months. So that’s a really important thing for men to do.

Answer from: Renata Finelli

Embryologist, Junior Embryologist at CREATE Fertility
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There are different symptoms that may be associated with varicoceles. In some cases it is totally symptomatic, meaning it is identified during a routine male fertility assessment. In other cases, men can experience a feeling of heaviness in the scrotum or discomfort on a particular side of the scrotum. It is most important to remember that it is most common on the left side for anatomical reasons. Another symptom that men can observe is that the testicle is smaller on the side where the dilated veins are, so it is very important to observe ourselves and discuss with our physician any small symptom that we may experience.

About this question:

How varicoceles affect sperm parameters?

Does varicocele affect sperm count? How does varicocele affect sperm production? How does varicocele affect sperm motility?

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