Varicocele Evaluation and Treatment

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A varicocele is an enlargement of veins around the testis. Many varicoceles cause no symptoms and do not require treatment. In some men, a clinically detectable varicocele may be associated with discomfort, reduced testicular growth or abnormal semen parameters.

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When Is Treatment Considered?

- A palpable varicocele on clinical examination
- Infertility with abnormal semen results
- Testicular discomfort that persists despite conservative care
- Reduced testicular development in selected younger patients
- A shared decision after discussing alternatives and the female partner’s fertility status

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Evaluation
- Medical and fertility history
- Scrotal examination
- Semen analysis, often repeated
- Hormonal tests when indicated
- Scrotal ultrasound in selected situations
- Assessment of the couple’s overall treatment timeline

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Treatment Options

Observation
No intervention may be required when the varicocele is small, asymptomatic and not associated with a relevant fertility or testicular concern.
Varicocele repair
Microsurgical or other surgical approaches may be used to interrupt abnormal veins while preserving arteries and lymphatic channels. Embolisation is another option in selected centres.

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Possible Risks
- Hydrocele
- Recurrence or persistence
- Bleeding or infection
- Testicular artery injury, which is uncommon
- No improvement in semen parameters or pregnancy outcome