Testicular Varicocele

Testicular varicocele is considered a culprit for the occurrence of infertility-fertility in men.

What is testicular varicocele?

Varicocele is a relatively common condition that occurs in 11% of men without problems and in 25% of infertile men. It is actually an enlargement (varicose) of the veins responsible for draining blood from the testicle.

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What are the symptoms?

Varicose usually occurs in the left testicle for anatomical reasons but can also occur in the right testicle or in both. As a result of this condition, the blood no longer circulates properly and thus various problems can occur. For many men, this condition is completely asymptomatic. They do not perceive anything abnormal and find it out during infertility tests.

Other patients suffer a feeling of heaviness, discomfort or itching in the affected testicle. While a small varicose vein is not detectable, a large varicose vein can be felt by the patient himself as a soft mass, usually painless, on the upper part of the testicle.

The most important problem, however, is the infertility it causes since for various reasons which ultimately affect the microenvironment of the testicle, normal spermatogenesis is prevented.


To diagnose varicocele, clinical examination and Doppler ultrasound are necessary. If the varicocele is severe, the andrologist will diagnose the condition almost immediately, as long as the patient stands upright to palpate the dilated veins.

If the varicocele, in addition to the upright position, is also visible when lying down, the posterior peritoneal space is also checked, as it is possible that there is a neoplasm that puts pressure on the seminal vein.

The doctor will perform a Doppler ultrasound to diagnose a relatively small varicose vein that is not visible to the naked eye.

This examination shows if –along with the increase in intra-abdominal pressure- there is also an increase in the veins, resulting in blood regression.

Which is the appropriate treatment and when is surgery performed?

When a man has a subclinical varicocele, no treatment is required. However, it must be monitored systematically both in terms of the degree of varicocele and the disorders it causes. Deterioration of the examined parameters is an indication for treatment.

If there is varicocele, sperm disorders and infertility at the same time, treatment is required. It should be noted, however, that correcting the problem does not necessarily mean improving sperm.  The varicocele may have been treated effectively but the testicle may no longer be able to return to normal function and spermatogenesis. The appropriate treatment for varicose veins is surgery.

Although various techniques have been tried (open method, laparoscopic), microsurgery is considered better. In this technique, a small incision is made in the side of the penis, i.e. where the sperm tone passes and with the use of a microscope, the problematic veins are identified and ligated.   After the surgery, the doctor provides tips for quick and painless recovery.

With the long experience of Androclinic’s doctors, the surgery does not require hospitalization and the patient can return home after a while. To find out the cost of the surgery, please contact the clinic.

The doctor will make a Doppler ultrasound to diagnose a relatively small varicocele that is not visible to the naked eye.

Frequently asked questions

Are all Vericose Veins the same?

The severity of the varicose veins can vary. it can be small and found only via ultrasound or it can be very large and be seen even through a simple examination.

How Vericocele Veins and infertility are connected?

Due to the fact that varicose veins often develop over the years, a young man with varicocele who has however normal sperm at the time of the diagnosis of the varicocele, is not sure that his varicocele will remain stable or that his sperm will remain unchanged.

Therefore, every man who is diagnosed with varicocele should perform a sperm test to check the quality of his sperm.

Although various forms of damage can be observed in the sperm of a man due to varicocele, disorders are often observed in all parameters of sperm, i.e. in the number, mobility and morphology of the sperm, resulting in the appearance of oligoasthenospermia.

Why does it occur?

The veins have internal valves that allow blood to flow in only one direction, i.e. to the center of the body. When they begin to fail, there is a return and regression due to the gravity at the lowest points. The reason why valves are deficient is usually congenital, however factors such as weight lifting, standing etc., can make the symptoms of the disease more intense.

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